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• CITY OF ORONO 1 I I j 1 I I 1 I I L I1 I I I I I I 1 I I 1 II I <br /> 2750 KELLEY PARKWAY * 2017 - 012 3 <br /> DATE ISSUED: 09/28/22 017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4105 HIGHWOOD RD <br /> PIN : 07-117-23-44-0014 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 016 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (5)WATER CLOSETS,(6)LAVATORIES,(4)BATHTUBS,(1)SHOWER,(2)KITCHEN SINKS,(2)DISPOSALS,(3)DISHWASHERS, <br /> (2)SILLCOCKS,(1)FLOOR DRAIN,(2)LAUNDRY TRAYS,(1)WATER HEATER,(1)WET BAR <br /> VALUATION OF PLUMBING 21000 <br /> APPLICANT PLUMBING FIXTURE FEE 262.50 <br /> STATE SURCHARGE PLBG(VALUATION) 10.50 <br /> LEGEND SERVICES,INC <br /> P 0 BOX 382 TOTAL 273.00 <br /> LORETTO,MN 55357- Payment(s) <br /> (763)479-5002 CHECK 8280 273.00 <br /> Minnesota State License#:plbg-PC644501,mech-MB005090 <br /> OWNER <br /> PETERSON,JASON <br /> 4105 HIGHWOOD RD <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 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 /> 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 ca e. <br /> imEuL <br /> /L6- /i <br /> Applicant P rite Signa re Date Issued Signature Date <br />