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r , CITY OF ORONO * Z 0 1 6 - 0 0 4 5 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/28/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 787 BOULDER DR <br /> PIN : 33-118-23-11-0132 <br /> LEGAL DESC : STONEBAY <br /> : LOT 7&8 BLOCK 1 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (3)WATER CLOSETS,(4)LAVATOR[ES,(1)BATHTUB,(2)SHOWERS,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,(2) <br /> SILLCOCKS,(1)FLOOR DRAIN,(1)LAUNDRY TRAY,(1)WASHER,(1)WATER HEATER AND(1)WET BAR <br /> VALUATION OF PLUMBING 15000 <br /> APPLICANT PLUMBING FIXTURE FEE 187.50 <br /> STATE SURCHARGE PLBG(VALUATION) 7.50 <br /> SCHULTIES PLUMBING MAIL-IN FEE 2.00 <br /> 1521 94TH LANE NE <br /> BLAINE,MN 55449 TOTAL 197.00 <br /> (651)786-4007 Payment(s) <br /> Minnesota State License#:plbg-PC644177,mech-MB005379 CHECK 33598 197.00 <br /> OWNER <br /> Wooddale Builders <br /> 6117 BLUE CIR DR <br /> MINNETONKA, MN 55343- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[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 /> 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 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 due cause. <br /> � <br /> . <br /> C � v i �8i / <br /> Applicant Permitee Signature Date Issued Signature Date <br />