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' ` CITY OF ORONO PERMIT NO.: 2oiaoo�s9 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �SS[1ED: 09/02/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3980 CHERRY AVE <br /> PIN : 08-117-23-33-0026 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 000 BLOCK 005 <br /> PERM[T TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: NF,W PLUMBING FIXTURES INCLUDE: <br /> (4)WA"I'ER CLOSETS <br /> (5)LAVATORIES <br /> (2)BATHTUBS,(2)SHOWERS,(2)SILCOCKS,(2)FLOOR DRAINS <br /> (1)KI"t'CHEN SINK,(1)DISHWASHER,(1)LAUNDRY TRAY,(1)WASHER <br /> VALUATION OF PLUMBING 4500 <br /> APPLICANT PLUMBING FIXTURE FEE 56.25 <br /> CIRCLE PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 3882 EDITH LANE TOTAL 61.25 <br /> CIRCLE P[NES, MN 55014- <br /> (763)784-2267 <br /> OWNER <br /> SCHULTZ, KEVIN <br /> 5620 GIRARD AVE N <br /> MINNEAPOLIS,MN 55430- <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. Ail provisions of laws and ordinances governing this type of work <br /> shall be compied with whether 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 construc[ion is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring alI required inspections are <br /> requested in conf ance with the State Building Code.This permit may be <br /> revoked at ime�r due cause. - <br /> �J �J � -� <br /> / lQ� l �� ��J���Y U � � ��� <br /> AppliEant ermitee Signature Date Iss e By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />