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CITY OF ORONO PERMIT NO.: 2011-01559 <br /> � 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- �ATE ISSUEu: 12/16/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2620 FOX ST <br /> PIN : 04-117-23-42-0010 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1249 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WET BAR <br /> VALUATION OF PLUMBING 1300 <br /> APPLICAI�IT PLUMBING FIXTURE FEE 50.00 <br /> ROARK PLUMBING INC. STATE SURCHARGE PLBG(VALUATION) 0.65 <br /> 2415 WEST INDUSTRIAL BLVD. TOTAL 50.65 <br /> SUITE NO. 5 <br /> LONG LAKE, MN 55�68- <br /> (612)867-2521 <br /> OWNER <br /> JAFFRAY, MR. & MRS. <br /> 2620 FOX ST <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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or rela[ed work which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shaii be compicd with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced with' 1 0 days of the date of issuance,or if construction is <br /> suspended for a eri d of l80 days at any time after work has commenced. <br /> The appli nt is es onsible for assuring all required inspections are <br /> re uested co for ance with the State Building Code.This permit may be <br /> d a y n for due cause. <br /> �� � , ����-- i� /� , v <br /> Applica rmitee Signature Date Is d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />