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, . � <br /> CITY OF ORONO PERMIT NO.: 2012-00074 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 02/07/2012 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 420 BROWN RD S <br /> PIN : 03-117-23-42-0010 <br /> � LEGAL DESC : STRONGHOLD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: PLUMB[NG FIXTURES: <br /> (1)WATER CLOSET,(1)LAVATORY,(1)BATHTUB,(1)KITCHEN SINK,(1)DISHWASHER,(1)FLOOR DRAIN AND <br /> (1)LAUNDRV"I'RAY <br /> VALUATION OF PLUMBING 5000 <br /> 6 <br /> APPLICANT PLUMBING FIXTURE FEE 62.50 <br /> NOWTHEN PLUMBING STATE SURCHARGE PLBG(VALUATION) 2.50 <br /> 19960 FERRET ST. MAIL-IN FEE 2.00 <br /> ELK RIVER, MN 55330 <br /> (763)753-5216 TOTAL 67.00 <br /> PAID WITH CC# 5814 <br /> OWNER <br /> RASMUSSEN, KARL& KACEY <br /> 420 BROWN RD S <br /> LONG LAKE, MN 553�6- <br /> AGREEMENT AND SWORN STATEMENT <br /> i I i�e w�rk for which zhis permit is issued shall be performed according to <br /> tl�e approved pians and specifications,applicable City approvals,and the <br /> State Buildmg Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permrts. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date oC issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked a[any time for due cause. <br /> �'�2�P G� a l � l/ a-- l l /�-- <br /> Applicant Permitee ignature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />