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CITY OF ORONO � I III111ll i . 11.L ,11.� � 1 _ 1 � II <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/18/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 440 OLD LONG LAKE RD <br /> PIN : 36-118-23-34-0015 <br /> LEGAL DESC : SUMMIT STATION <br /> : LOT 008 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(2)LAVATORIES,(1)BATHTUB,(1)SHOWER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.25 <br /> GENZ-RYAN PLUMBING&HEAT MAIL-IN FEE 2.00 <br /> 2200 HIGHWAY 13 <br /> BURNSVILLE,MN 55337 TOTAL 52.25 <br /> (952)767-1838 Payment(s) <br /> Minnesota State License#:mech-MB003541 CREDIT CARD 9121 52.25 <br /> OWNER <br /> LEONARD&TRACI HOREJSI,THOMAS <br /> 440 OLD LONG LAKE RD <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 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 /> Applicant Permitee Signature Date Issued�e�'.ignature Date <br />