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' ' CITY OF ORONO PERMIT NO.: 2009-00169 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 5535C- DATE ISSUED: 04/2U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2623 CASCO POINT RD <br /> PIN : 20-117-23-24-0032 <br /> LEGAL DESC : SPRING PARK <br /> : LOT 141 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: <br /> PLUMBING FIXTURES INCLUDE: <br /> (4)WATER CLOSETS,(5)LAVATORIES,(2)BATHTUBS,(2)SHOWERS,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,(2) <br /> SILLCOCKS,(2)FLOORS DRAINS,(1)LAUNDRY TUB,(1)WAHSER,(1)WATER HEATER,AND(1)WATGR SOFTENER <br /> VALUATION OF PLUMBING 12000 <br /> APPLICANT PLUMBING FIXTURE FEE 150.00 <br /> RICK'S PLUMBING, INC. STATE SURCHARGE PLBG (VALUATION) 6.00 <br /> 1701 221ST AVE.NW TOTAL 156.00 <br /> CEDAR, MN 55011-4232 <br /> (763)753-1935 <br /> OWNER <br /> KUBALAK,THOMAS& PATRICIA <br /> 2623 CASCO PO1NT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Yor which this permit is issued shall be performed according to <br /> thc 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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenccd within 180 days of the date of issuance,or if construc[ion 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 at an time for due'�r <br /> =� ' / � 2j ���� / / <br /> plicafiF� ermitee Signature Date Issued By Signature Date <br /> % <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />