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CITY OF ORONO * Z 0 1 5 - 0 0 3 9 5 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 04/09/2015 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3460 BIRCH LA <br /> PIN : 08-117-23-43-0027 <br /> LEGAL DESC : LYDIARDS PARK LAKE MTKA <br /> : LOT 019 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 3 WATER CLOSETS,5 LAVATORY, 1 BATHTUB,2 SHOWER, 1 WASHER <br /> VALUATION OF PLUMBING 16900 <br /> APPLICANT PLUMBING FIXTURE FEE 211.25 <br /> STATE SURCHARGE PLBG(VALUATION) 8.45 <br /> SWANSON PLUMBING INC. TOTAL 219.70 <br /> 16591- 351 AVENUE Payment(s) <br /> HAMBURG, MN 55339 CHECK 2944 219J0 <br /> (612)508-9474 <br /> Minnesota State License#: plbg-643453 <br /> OWNER <br /> LISLE, STEVE&ANGELA <br /> 3460 BIRCH LA <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. AII 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 the State Building Code.This permit may be <br /> revoked at any time for due cause <br /> �s� �9� /s' ; ,�;��� c,-�-}-u��� �"' y , � , � � <br /> Applicant P mitee Signature Date Issued By Signature Date <br />