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CITY OF ORONO 1 1 11 1 1 11 11 1 11 11 11 111 1 11,1 111 1 <br /> 21w0s3 * <br /> 2750 KELLEY PARKWAY * DANE ISR5/05/20185 <br /> • ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 450 OLD CRYSTAL BAY RD N <br /> PIN : 33-118-23-13-0020 <br /> LEGAL DESC : CRYSTAL BAY BUSINESS CENTER 2ND ADD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 7 WATER CLOSETS,5 LAVATORIES, 1 KITCHEN SINK,URINAL,5 FLOOR DRAINS, 1 MOP SINK,2 WATER HEATERS, I <br /> EYEWASH, <br /> 2 WASH FOUNTAINS, 1 WATER COOLER <br /> VALUATION OF PLUMBING 42000 <br /> • <br /> APPLICANT PLUMBING FIXTURE FEE 525.00 <br /> STATE SURCHARGE PLBG(VALUATION) 21.00 <br /> NORTHERN MECHANICAL MAIL-IN FEE 2.00 <br /> 1975 SENECA RD <br /> EAGAN,MN 55122- TOTAL 548.00 <br /> (651)789-2275 Payment(s) <br /> CHECK 3259 548.00 <br /> OWNER <br /> Jem Technical <br /> 450 OLD CRYSTAL BAY RD N <br /> LONG LAKE,MN 55356- <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 cause. <br /> f �C� 1 6-L� --��-u- � ✓t 5 is <br /> Applicant Permitee Signature / Date Issued By Signature Date <br />