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CITY OF ORONO 111011111111111111111111111111111111111111111111 <br /> * 20 1 5 - 0 0 2 2 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/23/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 625 FERNDALE RD N <br /> PIN : 36-118-23-11-0021 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 3 WATER CLOSETS,4 LAVATORY,2 BATHTUBS,2 SHOWERS <br /> VALUATION OF PLUMBING 22710 <br /> APPLICANT PLUMBING FIXTURE FEE 283.88 <br /> STATE SURCHARGE PLBG(VALUATION) 11.36 <br /> SPRING PLUMBING LLC MAIL-IN FEE 2.00 <br /> 11473 KENYON COURT <br /> BLAINE,MN 55449- TOTAL 297.24 <br /> (763)614-7963 Payment(s) <br /> Minnesota State License#:plbg-066807 PM CHECK 09822 297.24 <br /> OWNER <br /> GLAD,CARSON&KAROLIEN <br /> 625 FERNDALE RD N <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 /> Y1 i &d ( yCVI o?/ <br /> Applicant Permitee Signature Date Issued By Signature Date <br />