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r , � <br /> CITY OF ORONO * z 0 1 5 - 0 1 1 0 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/OU2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2470 CARMAN ST <br /> PIN : 20-117-23-12-0066 <br /> LEGAL DESC : LEHMAN LAGOON <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (6)WATER CLOSETS,(9)LAVATORIES,(3)BATHTUBS,(3)SHOWERS,(2)KITCHEN SINKS,(1)DISPOSAL,(1)D[SHWASHER, <br /> (2)SILLCOCKS,(2)FLOOR DRAINS,(2)LAUNDRY TRAYS,(1)WASHER,(1)WATER HEATER,(1)WET BAR <br /> VALUATION OF PLUMBING 15000 <br /> APPLICANT PLUMBING FIXTURE FEE 187.50 <br /> STATE SURCHARGE PLBG(VALUATION) 7.50 <br /> DIVERSIFIED PLUMBING TOTAL 195.00 <br /> POBOX91 <br /> CHASKA, MN 55318- Payment(s) <br /> (763)221-5441 CHECK 5248 195.00 <br /> Minnesota State License#: PLUM-71354924 <br /> OW1vER <br /> JARNES,JEFF&JACQ <br /> 2470 CARMAN ST <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 whe[her or not specified herein.This permi[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 /> � �/ � �� <br /> Appli t Permitee Signature Date [ sue y Signature Date <br />