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CITY OF ORONO * 2 0 1 6 - 0 1 5 1 8 * <br /> 2750 KELLEY PARKWAY �ATE [SSUED: 12/OS/2016 <br /> �- ORONO, MN 55356- <br /> f (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3010 SOMERSET LA <br /> PIN : 04-117-23-22-0029 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (2)WATER CLOSETS,(3)LAVATOIRES,(1)BATHTUB,(1)SHOWER <br /> MATER BATH REMODEL-ROUGH-IN AND FINISH <br /> REPLACE TOILET AND LAV IN 1/2 BATH <br /> VALUATION OF PLUMBING 3200 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.60 <br /> LEGEND SERVICES,INC <br /> 201 N MEDINA ST TOTAL 51.60 <br /> P O BOX 382 Payment(s) <br /> LORETTO, MN 55357- CREDIT CARD 5960 51.60 <br /> (763)479-5002 <br /> Minnesota State License#: mech-MB005090 <br /> OWNER <br /> BUTLER, PATRICK&JILL <br /> 3010 SOMERSET LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shali 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 Ihe State Building Code.This permit may be <br /> revoked at�ny time for�cause. ��i <br /> ���? ���� �, ,) `/�-��t;t.C`--� j � G=-- �D <br /> �� ; ` � � � � l <br /> Applicant Permitee Signature Date Issued y Signat re Date <br />