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CITY OF ORONO * z 0 1 5 - 0 0 2 1 8 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 02/24/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2775 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0016 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: 1 WATER CLOSET, 1 LAVATORY, 1 SHOWER <br /> VALUATION OF PLUMBING 9550 <br /> APPLICANT PLUMBING FIXTURE FEE 119.38 <br /> STATE SURCHARGE PLBG(VALUATION) 4.78 <br /> B&D PLUMBING&HEATING INC. TOTAL 124.16 <br /> 4145 MACKENZIE CT NE Payment(s) <br /> ST MICHAEL, MN 55376- CHECK 549879 124.16 <br /> (763)497-2290 <br /> OWNER <br /> MURLEY,TODD& MARY <br /> 2755 COUNTRYSIDE DR W <br /> LONG LAKE,MN 55356 <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 goveming this type of work <br /> sha11 be compied wi[h 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 of 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 at any time for d e cause. <br /> =� ,�-�--�-���� � � /�/ r� <br /> � <br /> pplicant Permitee Signa re Date Issued By Signature Date <br />