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, CITY OF ORONO � p� 1 5 - PJ 0 7 7 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/16/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1291 BRIAR ST <br /> PIN : ]0-117-23-31-0043 <br /> LEGAL DESC : CRYSTAL BAY M[NNETONKA <br /> : LOT 000 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET <br /> (2)LAVATORIES <br /> (1)SHOWER <br /> VALUATION OF PLUMBING 1100 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.55 <br /> LEGEND SERVICES, INC TOTAL 50.55 <br /> 201 N MEDINA ST Payment(s) <br /> P O BOX 382 CREDIT CARD 1282 50.55 <br /> LORETTO, MN 55357- <br /> (763)479-5002 <br /> Minnesota State License#:mech-MB005090 <br /> OWNER <br /> KELLETT,KEVIN CURLEY&W <br /> P.O. BOX 41 <br /> CRYSTAL BAY, MN 55323- <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 /> Sta[e Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separa[e <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whe[her or no[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 I80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> . <br /> �'� S� i /�i /S <br /> Applicant Permitee Signature Date Issu d By Signature Date <br />