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CITY OF ORONO *� 4 - 0 0 2 2 0 * <br /> . � 2750 KELLEY PARKWAY DATE ISSUED: 03/18/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 35 CRYSTAL CREEK RD <br /> PIN : 33-118-23-33-0002 <br /> LEGAL DESC : CRYSTAL CREEK <br /> : LOT 001 BLOCK OOl <br /> PERMIT TYPE : PLUMBING (> $500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: PLUMBING FIXTURES: (l)LAVA"CORY,(1)BATI3TUB,AND(1)SE{OWER <br /> VALUATION OF PLUMBING 3000 <br /> APPLICAI�IT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG (VALUATION) 1.50 <br /> KOEHLER, STEVEN&ANNE TOTAL 51.50 <br /> 35 CRYSTAL CREEK RD Payment(s) <br /> LONG LAKE, MN 55356 CREDIT CARD 6705 51.50 <br /> OWNER <br /> KOEHLER, STEVEN &ANNE <br /> 35 CRYSTAL CREEK RD <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 /> Ihe approved plans and specifica[ions,applicable City approvals,and the <br /> State[3uilding 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 specif ied herein.This permit will <br /> expire and become null and void if construction audiorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended tbr a period of 180 days at any time after work has commenced. <br /> l he applicant is responsible for assuring all required inspections are <br /> requested in contormance with the State Building Code.This permit may be <br /> revoked at any time for duc cause. <br /> , � ��� l�- � /� <br /> � �' � �� � <br /> Applicant Permitee Signature Date Issue y Signature Date <br />