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. � , <br /> CITY OF ORONO * 2 0 1 2 - 0 0 6 2 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/29/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3300 FOX ST <br /> PIN : OS-117-23-44-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1358 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: PLUMBING [�IXTURGS(1)EACH: KITCHEN SINK, DISPOSA[,AND D[SHWASHGR <br /> VALUAT[ON OF PLUMB[NG 900 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> NOWTHEN PLUMBING STATE SURCHARGE PLBG (VALUATION) 0.45 <br /> 19960 FERRET ST. <br /> ELK RIVER, MN 55330 MAIL-IN FEE 2.00 <br /> (763)753-5216 TOTAL 52.45 <br /> PAID W[TH CC# 5814 <br /> OWNER <br /> TRUBECK, W[LLIAM&JUDITH <br /> 3300 FOX ST <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit 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 related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 applicant is responsible for assuring all required inspections are <br /> requested in conti�rmance with the State Building Code.This permit may be <br /> revoke t any time for due cause. <br /> , �� Z�� /� � 21� 12� <br /> Applicant Permitee Signature Date Issu By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />