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.,. <br /> � <br /> CITY OF ORONO P�aM�T No.: 2oii-oo33a <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �SSUEn: OS/12/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2650 FOX ST <br /> PIN : 04-117-23-41-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1249 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: PLUM131NG FIX"CURGS: <br /> (3)WATER CLOSETS,(4)LAVATORIES.(1)BA"C[ITUB,(2)SHOWGRS,(1)KITCHEN SINK,(1)DISHWASHER,(1)FLOOR DRAIN AND <br /> (1)WASHER <br /> VALUATION OF PLUMBING 5500 <br /> APPLICANT PLUMBING FIXTURE FEE 68.75 <br /> AMERICAN MECHANICAL CO, INC. STATE SURCHARGE PLBG (VALUATION) 2.75 <br /> 7120 71ST AVE.N. TOTAL 71.50 <br /> PO BOX 205 <br /> LORETTO, MN 55357- PAID WITH CC# 9327 <br /> (612)750-0278 <br /> Minnesota State License#: 065381 PM <br /> OWNER <br /> PAULSON, STEPHEN <br /> 2650 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMEI�T 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,��nd the <br /> State[3uilding Code. 'This permit is for only the work described and does <br /> not grant permission for additional or related work���hich requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified hercin.This pennit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter�jork has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> re uested in ca ormance with the State Building Code.This permit may be <br /> e ked a[ �ti for due causc. <br /> � �� ! � � �� <br /> �/ /02�� �I <br /> ppli nt Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />