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CITY OF ORONO PERMIT NO.: 2011-00452 <br /> 2750 KELLEY PARKWAY <br /> , ORONO, MN 55356- �ATE issUEn: 06/13/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 120 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0014 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES -MULTIPLE <br /> NOTE: 5 WATF..R CLOSETS,7 LAVATOR[GS,2 BATHTUBS,2 SHOWGRS, 1 KITCHGN SINK, 1 DISPOSAL, 1 DISHWASHER,2 <br /> SILLCOCKS,3 FLOOR DRAINS,2 LAUNDKY TRAY, 1 WASHL:R, 1 WATER HF,ATF,R,2 WET BAR <br /> VALUATION OF PLUMBING 25000 <br /> APPLICANT PLUMBING FIXTURE FEE 312.50 <br /> BLUE WATER PLUMBING STATE SURCHARGE PLBG(VALUAT[ON) 12.50 <br /> 5026 ALPHA ROAD <br /> PRINCETON, MN 55371 TOTAL 325.00 <br /> (763)238-1002 <br /> OWNER <br /> GUSTAFSON, MICHAEL& SUSAN <br /> 1000 SHELARD PKWY#300 <br /> MINNEAPOLIS, MN 55426- <br /> AGREEMENT AND SWORN STATEMENT _ <br /> The«ork 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 rclated 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 authorizcd 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[ime atter work has commenced. <br /> "Che 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 /> � �- :i <br /> :�--�-����- 6 / i 3 / �/ �=,��.--� � �`�'Y� C �%� � � ��.� /� <br /> � icant Permitee S�gnature Date lssued�y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />