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CITY OF ORONO * Z 0 1 6 - 0 PJ 9 9 6 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 08/18/2016 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1885 CONCORDIA ST <br /> PIN : 17-117-23-23-0002 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: NEW FIXTURES:6 WATER CLOSETS,7 LAVATORY, I BATHTUB,4 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL,2 DISHWASHER, <br /> 2 SILCOCKS, <br /> 6 FLOOR DRA[NS, 1 LAUNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WET BAR <br /> VALUATION OF PLUMBING 41556 <br /> APPLICAi�IT PLUMBING FIXTURE FEE 519.45 <br /> STATE SURCHARGE PLBG(VALUATION) 20.78 <br /> FREEDOM MECHANICAL TOTAL 540.23 <br /> 8382 172ND AVE SE <br /> BECKER, MN 55308- Payment(s) <br /> (612)363-6190 CHECK 7333 540.23 <br /> Minnesota State License#: mech-004042PM,plbg-PC642836 <br /> OWNER <br /> KAISER,BERNARD&CAROLYN <br /> 2855 PROVIDENCE PLACE <br /> INDEPENDENCE,MN 55359- <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 pemiission 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 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 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 �r' <br /> revoked at any time for ue caus �. G�Y� <br /> "1 <br /> . � :�-i`,�' —/� ���c� �1 I�����f �j� 8"� � �" l ��, <br /> Applicant Permitee Signature Date Issued By Signature Date <br />