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, CITYOFORONO * 20 1 Z - PJ0393 * <br /> 2750 KELLEY PARKWAY DATE ISSUEU: OS/10/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 510 DEBORAH DR <br /> PIN : 31-118-23-23-0006 <br /> LEGAL DESC : MCCULLEY FARM <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES - MULTIPLE <br /> NOTG: 2ND FLOOR: 1 WC,2 LAV, 1 TU�3. 1 SHOWER <br /> VALUAT[ON OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> SUNDERLAND PLBG INC STATE SURCHARGE PLBG (VALUATION) 1.25 <br /> 24380 RIVER BANK LANE TOTAL 51.25 <br /> ISANTI, MN 55040- <br /> (763)753-2845 <br /> OWNER <br /> WELTY, CHRISTOPHER& PATRIC[A <br /> 510 DEBORAH DR <br /> MAPLE PLA[N, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfom�ed according to <br /> [he approved plans and specitications,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 rela[ed work which requires separate <br /> perrnits. All provisions of laws and ordinances governing 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 afrer work has commenced. <br /> The appl an s responsible for uring all required inspections are <br /> requeste in c formance i he 'tate Building Code.This permit may be <br /> reve�Jced aZ y ime or e use <br /> � � �/ ��(� � ��'� / / <br /> Ap�licant Permitee Signature Date Issued By Sig re D e <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />