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' CITY OF ORONO * Z 0 1 5 - 0 0 3 1 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/18/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 99 SIXTH AVE N <br /> PIN : 25-118-23-44-0012 <br /> LEGAL DESC : HOLLY ACRES 2ND ADDN <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (2)WATER CLOSETS <br /> (3)LAVATORIES <br /> (1)SHOWER <br /> (1)BATHTUB <br /> VALUATION OF PLUMBING 4475 <br /> APPLICANT PLUMBING FIXTURE FEE 55.94 <br /> STATE SURCHARGE PLBG(VALUATION) 2.24 <br /> NOWTHEN PLUMBING MAIL-IN FEE 2.00 <br /> 19960 FERRET ST. TOTAL 60.18 <br /> ELK RIVER,MN 55330 <br /> (763)753-5216 Payment(s) <br /> CREDIT CARD 3512 60.18 <br /> OWNER <br /> BRISCOE,MR.&MRS. <br /> 99 SIXTH AVE N <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shail be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming 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 e State Building Code.This permit may be <br /> revoked at time for du2�caus . <br /> �.-�J �'�/� <br /> Applicant Permitee Signature Date Issued y Signature Date <br />