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R <br /> ' CITY OF ORONO * Z 0 1 4 - 0 0 9 4 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2014 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 145 MANOR CIR <br /> PIN : 04-117-23-11-0024 <br /> LEGAL DESC : COUNTRYSIDE MANOR 3RD ADDITION <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (1)WATER CLOSET,(1)LAVATORY,(1)BATHTUB,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWAASHER <br /> VALUATION OF PLUMBING 3000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.50 <br /> WATERTOWN PLUMBING TOTAL 51.50 <br /> 604 HILLSIDE DRIVE NW <br /> WATERTOWN, MN 55388- Payment(s) <br /> (952)255-8212 CHECK 6207 51.50 <br /> Minnesota State License#: plbg-PC644088 <br /> OWNER <br /> NAFSTAD,ADAM&KRISTIN <br /> 145 MANOR CIR <br /> LONG LAKE,MN 55356- <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 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 aIl required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any ti e for due cause. <br /> � Zj' / � ,ot�.i� <br /> licant Permitee Signature Da e Is d By Signature Date <br />