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, • • <br /> CITY OF ORONO PERMIT NO.: 2009-00504 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �A7'E tssuEn: 08/19/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3485 CRYSTAL PL <br /> PIN : 17-117-23-43-0011 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 008 BLOCK 002 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES - MULTIPLE <br /> NOTE: ROUGH IN P'OR FUTURF,WATER CLOSET AND FLOOR DRAIN. <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> LARSON,JASIN STATE SURCHARGE PLBG (<$500) 0.50 <br /> 3485 CRYSTAL PL <br /> WAYZATA, MN 55391- TOTAL 15.50 <br /> PAID WITH CC# 6969 <br /> OWNER <br /> LARSON,JASIN <br /> 3485 CRYSTAL PL <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be peribrmed according to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not gran[permission for additional or rclated work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whethcr or not specified herein."I his 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."I his permit may be <br /> revoked a y time for due cause. <br /> � / �� / �� / / <br /> Ap ant mrtee Signalure Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />