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� � <br /> CITY OF ORONO * 2 0 1 7 - 0 0 1 8 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/24/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2995 DEER RUN TR <br /> PIN : 04 117-23-23-0030 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : F(XTURES-MULT[PLE <br /> NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)KITCHEN S[NK,(I)WASHER,(1) WET BAR,(1) PREP SINK <br /> VALUATION OF PLUMBING 3500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> C&N PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.75 <br /> 11926 SUMMERSET LANE MAIL-IN FEE 2.00 <br /> BURNSVILLE, MN 55337- TOTAL 53.75 <br /> (612)419-0664 Payment(s) <br /> Minnesota State License#: plbg-MB005092 CHECK 6739 53.75 <br /> OWNER <br /> LEISCHOW, KELLY <br /> 2995 DEER RUN TR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AIYD 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 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 /> commeneed 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 /> revoked at any time for due cause. <br /> � � �:�-- �-� a , � <br /> Applicant Permitee Signature Date Issued By Sig�ture Date <br />