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4 ' ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 3 - 0 0 PJ 5 4 * <br /> DATE ISSUED: OU22/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2675 PHEASANT RD <br /> PIN : 21-117-23-23-0010 <br /> LEGAL DESC : PHEASANT LAWN <br /> : LOT 006 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: REPLACE WATER HEATER <br /> VALUATION OF PLUMBING 750 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> ADAMS ON TIME PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.38 <br /> 13791 JONQUIL LN N <br /> DAYTON,MN 55327- MAIL-IN FEE 2.00 <br /> TOTAL 52.38 <br /> PAID WITH CC# 9200 <br /> OWNER <br /> ROE,DAVID&NATALIE <br /> 2675 PHEASANT RD <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which�is 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � i a�-i � / lo�� /3 <br /> Applicant ermitee ' ature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />