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� <br /> . <br /> CITY OF ORONO PERMIT NO.: 2011-00017 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OU05/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADURESS : 1985 FAGERNESS POINT RD <br /> PIN : 18-117-23-14-0004 <br /> LEGAL DGSC : FAGERNESS <br /> : LOT 003 BLOCK 000 <br /> NERMIT TYPE ; PLUMBING (> $500) <br /> YROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTl7RES- MULTIPLE <br /> NO"I�G: PLUMBING FIX"IURGS-(4)WAl�1;R CLOSETS,(�)LAVA'CORIBS,(2)13A"I'll"fUQS,(1)KITCIII�N SINK, (1)DISHWnS11GR, <br /> (2)SILLCOCKS,(1 GACH)PLOOR DRAIN, LAUNDRY TRAY, WASI IER, WATER F11?ATGR, WATER SOFTLNER <br /> VALUATION OF PLUMBING 12000 <br /> APPLICANT PLUMBING FIXTURE FEE 150.00 <br /> BEN SCHORER PLUME3ING& HVAC INC. STATE SURCHARGE PLBG(VALUATION) 6.00 <br /> 4520 85TH STREET SE <br /> DELANO, MN 55328- TOTAL 156.00 <br /> (763)972-8137 <br /> OWNER <br /> BRIGGS, MATTHEW& ALISSA <br /> 1985 FAGEKNESS PT RD <br /> WAYZA"fA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> 7�he work for which this permit is issued shall be perfonned accordin�to <br /> thc approved plans and specitications,applicable City approvals,and the <br /> State Building Code. "I'his pennit is for onh�the�cork describcd and does <br /> � not grant permission lar additional or rellted work�vhich requires separate <br /> pernuts. All provisions of la�vs and ordinanccs govcrning this typc of work <br /> shall be compicd with���hether or not speci�ied hcrcin.This permit will <br /> expire and becomc null and void if construction authorized is not <br /> commenced���ithin 180 days of the date of issuance,or if construction is <br /> suspended 1or a period of I RO days at any time after���ork has commenced. <br /> fhe applicant is responsible for assurine all required inspections are <br /> requcsted in conlorn�ance with the State Buildin�Code.This permit may bc <br /> revoked at any time lor due cause. <br /> `� �-� / � �'� �.p lJ �y��- /� �� /� <br /> Applicant Permitee Signature ��a�� Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />