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. CITY OF ORONO PERMIT NO.: 2009-00104 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 03/11/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2811 FARVIEW LA <br /> PIN : 04-117-23-34-0003 <br /> LEGAL DESC : FARVIEW <br /> : LOT 012 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: BASEMENT: 1 WC, 1 f3ATHTUB <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> SOUTHTOWN PLUMBING INC. STATE SURCHARGE PLBG (<$500) 0.50 <br /> 6636 PENN <br /> RICHFIELD,MN 55423 MAIL-IN FEE 2.00 <br /> (612) 866-3057 TOTAL 17.50 <br /> Minnesota State License#: 60956PM <br /> OWNER <br /> TABNER& MICHEAL BOARDMAN, KATHRYN <br /> 281 1 FARVIEW LA <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The���ork for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This pennit 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 whether or not specitied herein.This pennit 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 tor a period of 180 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confom�ance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />