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1 . CITY OF ORONO PERMIT NO.: 2011-01186 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/04/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 450 WILLOW DR S <br /> PIN 03-117-23-32-0012 <br /> LEGAL DESC UNPLATTED 03 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (3)WATER CLOSETS,(5)LAVATORIES,(2)BATHTUB,(2)SILLCOCKS,AND <br /> (1)EACH-SHOWER,KITCHEN SINK,DISHWASHER,FLOOR DRAIN,LAUNDRY TRAY,WASHER, <br /> WATER HEATER AND WATER SOFTENER <br /> VALUATION OF PLUMBING 7000 <br /> APPLICANT PLUMBING FIXTURE FEE 87.50 <br /> BEN SCHERER PLUMBING&HVAC INC. STATE SURCHARGE PLBG(VALUATION) 3.50 <br /> 4520 85TH STREET SE TOTAL 91.00 <br /> DELANO,MN 55328- <br /> (763)972-8137 <br /> OWNER <br /> BOWMAN, WILLIAM <br /> 450 WILLOW DR S <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 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 the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> App icant Permitee Signature Date <br /> Issue By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />