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, , CITY OF ORONO * 2 0 1 7 — 0 0 0 0 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU05/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1565 FAIRVIEW COTTAGE LA <br /> PIN : 07-117-23-43-0033 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)BATHTUB,(1)KITCHEN SINK,(1)DISPOSAL,(1)D[SHWASHER,(2)FLOOR DRAINS, <br /> (1)WASHER <br /> VALUATION OF PLUMBING 11000 <br /> APPLICANT PLUMB[NG FIXTURE FEE 137.50 <br /> PAVEK PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.50 <br /> TOTAL l 43.00 <br /> 4550 COUNTY RD l0 N Payment(s) <br /> WATERTOWN,MN 55388 CREDIT CARD 9574 143.00 <br /> �) <br /> Minnesota State License#: BUIL-60617-PM <br /> OWNER <br /> MARY SNYKER BECKER, TIMOTHY BECKER& <br /> 1565 FAIRVIEW COTTAGE LANE <br /> MOUND, MN 55364- <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 Ciry 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 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �_ /� <br /> GC� -� s-� l � � ��7 <br /> �o <br /> Applicant Permitee Signature Date Issued By gnature Date <br />