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� � <br /> � CITY OF ORONO rERMiT No.: 2oiaooi2� <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssuEn: 03/08/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4149 HIGHWOOD RD <br /> PIN : 07-117-23-44-0018 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 022 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (2)WATER CLOSETS,(3)LAVATORIES,(1 EACH)BATHTUB,SHOWER,KITCHEN SINK,DISHWASHER <br /> VALUATION OF PLUMBING 9900 <br /> APPLICANT PLUMBING FIXTURE FEE 123.75 <br /> ABOVE&BEYOND PLUMBING INC STATE SURCHARGE PLBG(VALUATION) 4.95 <br /> 6431 153RD LANE NW TOTAL 128.70 <br /> RAMSEY,MN 55303- <br /> (763)360-6568 <br /> Minnesota State License#: 70645526 <br /> OWNER <br /> KOCH,MARK&NANCY <br /> 4149 HIGHWOOD RD <br /> MOLJND,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 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 sepazate <br /> permiu. 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 consUvction 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 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 /> revo y time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />