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CITY OF ORONO * z 0 1 2 - 0 0 z 5 z * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 04/04/2012 <br /> � ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2865 LITTLE ORCHARD WAY <br /> PIN : 09-117-23-21-0010 <br /> LEGAL DESC : LITTLE ORCHARD <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: BASEMENT:3 WC,3 LAV,3 SHOWER <br /> VALUATION OF PLUMBING 16063 <br /> APPLICANT PLUMBING FIXTURE FEE 200.79 <br /> RIVERSIDE MECHANICAL STATE SURCHARGE PLBG(VALUATION) 8.03 <br /> 12460 ZINRAN AVENUE <br /> SAVAGE,MN 5537& MAIL-IN FEE 2.01 <br /> MISC FEE 0.00 <br /> TOTAL 210.83 <br /> OWNER <br /> HOLMES,MARY <br /> 2865 LITTLE ORCHARD WAY <br /> WAYZATA,MN 55391- <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 /> 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 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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />