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NIMMMEMM <br /> CITY OF ORONO * 2 0 1 S — 0 0 0 5 9 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/20/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 1000 WILLOW DR S <br /> PIN 10-117-23-21-0004 <br /> LEGAL DESC UNPLATTED 10 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: (3)WATER CLOSETS,(4)LAVATORIES,(2)SHOWERS AND(1)FLOOR DRAIN <br /> VALUATION OF PLUMBING 10000 <br /> APPLICANT PLUMBING FIXTURE FEE 125.00 <br /> PRESSNALL PLUMBING <br /> STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> TOTAL 130.00 <br /> 2339 280TH STREET W Payment(s) <br /> RANDOLPH,MN 55065- CREDIT CARD 8743 130.00 <br /> Minnesota State License#:plbg-644158 <br /> OWNER <br /> KLOMBIES,LINDSAY&ANNA <br /> 1000 WILLOW DR S <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 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 nsible for uring all required inspections are <br /> requested in c fo ce wi a State Building Code.This permit may be <br /> revok an time or du use. <br /> rc a itee Signature Date Issue Signature Date <br />