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' ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * � 0 1 4 - PJ 0 4 2 6 * <br /> DATE ISSUED: OS/09/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 120 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0014 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMB[NG (> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTF,: PL.UMB[NG FIX['URF,S <br /> (1)WA'I�ER CLOSET,(1)LAVATORY. (l)SHOWt:R AND(1)SINK <br /> VALUAT[ON OF PLUMBING 1000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG (VALUATION) 0.50 <br /> GUSTAFSON, MICHAEL& SUSAN TOTAL 50.50 <br /> 1000 SHELARD PKWY#300 Payment(s) <br /> MINNEAPOLIS, MN 55426- CHECK 50.50 <br /> OWNER <br /> GUSTAFSON, MICHAEL& SUSAN <br /> 1000 SHELARD PKWY#300 <br /> MINNEAPOLIS, MN 55426- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work 1<�r which this permit is issued shall be performed accurding to <br /> the approved plans and specitications,applicable City approvals,and the <br /> S[atc Quilding Code. �I'his permit is for only the���ork described and does <br /> not grant permission for�dditional or related work which requires separate <br /> permits. All provisions of laws and ordinanees governing this type of work <br /> shall be compied w�ith whether or not specified herein.'1'his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 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 /> rhe applicant is responsible for assuring all required inspections are <br /> requested��c formance with the State Buildin� This permit may be <br /> revoked a� time for due cause <br /> �� <br /> � �. _ � � — <br /> %. <br /> �� �_. i <br /> ...�� ��'��-�(/�C._��L���r � � � !� �. <br /> p icant 1 ermitce Signature Datc Issued�3y Signalure Date <br /> v <br />