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CITYOFORONO * z013 - 00722 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 07/25/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1 10 CHEVY CHASE DR <br /> PIN : 36-118-23-41-0046 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 012 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: 1 LAUNDRY'TRAY, 1 KITCHEN SINK, l DISHWASHER <br /> VALUATION OF PLUMBING 3000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> NOWTHEN PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.50 <br /> 19960 FERRET ST. MAIL-IN FEE 2.00 <br /> ELK RIVER, MN 55330 <br /> (763)753-5216 TOTAL 53.50 <br /> PAID WITH CC# 5814 <br /> OWNER <br /> HIGGINS, KENNETH&LAURA <br /> 1 10 CHEVY CHASE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The�vork 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 goveming this type of work <br /> shall be compied with whether or not specitied 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 I 80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance withRhe State Building Code.This permit may be <br /> revoked at any time for�due cause. <br /> `�'1l.�Lc� � / / / / <br /> Applicant Permitee Signature Date [ssued By Sig a ure ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />