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4 <br /> CITY OF ORONO PERMIT NO.: 2009-00374 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 07/06/2009 <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 795 OLD CRYSTAL BAY RD N <br /> PIN : 28-118-23-34-0003 <br /> LEGAL DESC : UNPLATTED 28 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : INSTITUTIONAL-SCHOOL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: <br /> INSTALL(2)SHOWER VALVES AND REPLACE THE SHOWER DRAIN <br /> VALUATION OF PLUMBING 1300 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> SALZER PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.65 <br /> 6549 147TH STREET W. • TOTAL 50.65 <br /> SAVAGE,MN 55378 <br /> (952)447-8025 <br /> Minnesota State License#: 59058-PM <br /> OWNER <br /> 278,ORONO SCHOOL DIST NO. <br /> 795 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 /> 6 <br /> re 3ed at any time for due cause. / , <br /> / /7 Z51 9 <br /> Applican ermitee gnature DatC <br /> Iss -. By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />