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� � <br /> CITY OF ORONO * 2 0 1 4 - 0 0 1 0 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/03/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1161 ELMWOOD AVE <br /> PIN : 07-117-23-14-0029 <br /> LEGAL DESC : SKARP& LINDQUISTS FERNHILL LA <br /> : LOT 009 BLOCK 000 <br /> PERM[T TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES - MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (4)WATER CLOSETS,(6)LAVA"I'ORIES,(2)BATIITUBS,(2)SHOWERS,(I)KITCHEN SWK,(I)D(SPOSAL,(I)DISHWASf1E;R,(2) <br /> SILLCOCKS, <br /> (1)FLOOR DRAIN,(1)LAUNDRY"I'RAY,(1)WASHER,(1)WATER HEA"['ER,(1)WET E�AR <br /> VALUATION OF PLUMBIN(i 19070 <br /> APPLICANT PLUMBING FIXTURE FEE 238.38 <br /> STATE SURCHARGE PLBG (VALUATION) 9.54 <br /> SABRE HEATING &AIR COND INC. TOTAL 247.92 <br /> 15535 MEDINA ROAD <br /> PLYMOUTH, MN 55447 Payment(s) <br /> (763)473-2267 CREDIT CARD 0331 247.92 <br /> OWNER <br /> SUNDBERG, RICHARD <br /> 5125 WEST STREET <br /> GREENWOOD, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit 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 rela[ed 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 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�my time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspec[ions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ���c��d� �'�.��� � _ , �3 ,/ <br /> Applicant Permitee Signature Date [ssu� E3}�Signature Date � <br />