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, , CITY OF ORONO * z 0 1 7 — 0 0 7 1 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/27/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3490 BIRCH LA <br /> PIN : 08-117-23-43-0002 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(2)LAVATORIES,(1)SHOWER <br /> VALUATION OF PLUMBING 2800 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.40 <br /> VERSANT PLUMBING CO. <br /> 5601 331 AVE NW TOTAL 51.40 <br /> CAMBRIDGE,MN 55008- Payment(s) <br /> (763)238-4703 CREDIT CARD 4702 51.40 <br /> Minnesota State License#: plbg-643677 <br /> OWNER <br /> MISCHKE,TODD <br /> 3490 BIRCH LA <br /> WAYZATA, MN 55391- <br /> AGREEMEIVT 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 governing this type of work <br /> shall be compied with whether or not specified herein."Chis permit will <br /> expire and become null and void if construction authorized is not <br /> eommenced within 180 days of the date of issuance,or if construetion 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 /> 4�c,J��c � � ._�- �_ 1 � ,'C�lJ � i � 7i � <br /> Applicant Permitee Signature Date Issued Signature Date <br />