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� . � <br /> CITY OF ORONO * Z 0 1 S - 0 1 5 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/28/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 100 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0016 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (5)WATER CLOSETS,(7)LAVA"I'ORIES,(2)E3ATHTUBS,(3)SHOWERS,(])KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,(2) <br /> SILLCOCKS,(1)FLOOR DRAINS,(1)LAUNDRY TRAY,(1)WATER HEATER, (1)WASHER<(1)WET BAR <br /> VALUATION OF PLUMBING 30000 <br /> APPLICANT PLUMBING FIXTURE FEE 375.00 <br /> STATE SURCHARGE PLBG(VALUATION) 15.00 <br /> AMERICAN MECHANICAL CO, INC. MAIL-IN FEE 2.00 <br /> 7120 71ST AVE.N. <br /> PO BOX 205 TOTAL 392.00 <br /> LORETTO, MN 55357- Payment(s) <br /> (612)750-0278 CHECK 16250 392.00 <br /> OWNER <br /> PETERS, BARRY& KRIS <br /> 19210 HACKAMORE ROAD <br /> CORCORAN,MN 55340- <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 pennit 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 I80 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 bc <br /> revoked at any time for due cause. <br /> l`�0 �-eL��I� !v2 / 028�/_5 <br /> Applicant Permitee Signature Date Issued Signature Date <br />