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CITY OF ORONO * z 0 1 z - 0 1 1 9 5 * <br /> �� 2750 KELLEY PARKWAY �AT�ISSUEn: 1 U2U2012 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRES`' : 4495 BAYSIDE RD <br /> PIN �� : 06-117-23-21-0004 <br /> LEGAL DESC : UNPLATTED 06 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: (4)WATER CLOSETS,(5)LAVATORIES,(1)BATHTUB,(2)SHOWERS,(1)KITC[-IEN SWK,(1)DISHWASHER <br /> (2)SILLCOCKS,(2)FLOOR DRAINS,(1)LAUNDRY TRAY,(I)WASHER,(1)WATER HEATER AND(1)WATER SOFTENGR <br /> VALUATION OF PLUMBING 8000 <br /> APPLICANT PLUMBING FIXTURE FEE 100.00 <br /> CHEYENNE PLBG& HEATING INC STATE SURCHARGE PLBG (VALUATION) 4.00 <br /> 25903 RABBIT ST NW <br /> ZIMMERMAN, MN 55398- TOTAL 104.00 <br /> (763)856-6727 <br /> Minnesota State License#: PC644126 <br /> OWNER <br /> Katherine Taylor Homes, Inc. <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and beco �e null and void if construction authorized is not <br /> commenced w in 180 days of the date of issuance,or if consVuction is <br /> suspended o period of 18 days any time after work has commenced. <br /> The appl is respo i for urin II required inspections are <br /> reques � confor i e St e[3uilding Code.This pennit may be <br /> revo� d any ti r <br /> ./�%' �l �.�1 � /�- ��� 2�� �Z <br /> pp icant Permitee Signature Date Is I3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK O HER THAN DESCRIBED ABOVE. <br />