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' CITY OF ORONO PERMIT NO.: 2012-00004 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DA7'E IssUE�: 01103/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 805 FOREST ARMS LA <br /> PIN : 07-117-23-12-0009 <br /> LEGAL DESC : FOREST ARMS <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: BASEMENT: 1 WC, 1 LAV, 1 TUB, 1 FLOOR DRAIN. 1 LAUNDRY TRAY, 1 WATER I-fEATER, 1 WATER SOFTNER, I WET BAR <br /> iST FLOOR: 1 WC, 1 LAV, 1 KITCHEN SINK, l DISPOSAL, 1 DISHWASHER,2 SILLCOCKS, 1 WASHER <br /> 2ND FLOOR:2 WC,3 LAV,2 TUB, 1 SHOWG2 <br /> VALUAT[ON OF PLUMB[NG 7600 <br /> APPLICANT PLUMBING FIXTURE FEE 95.00 <br /> VODA PLUMBING STATE SURCHARGE PLBG(VALUATION) 3.80 <br /> 6417 PENN AVE. S. TOTAL 98.80 <br /> RICHFIELD, MN 55423- <br /> (612)282-9036 <br /> Minnesota State License#: 7598 <br /> OWNER <br /> GURALNIK,ALBERT&VALERIE <br /> 805 FOREST ARMS LA <br /> MOUND, MN 55364- <br /> AGREEMENT AIVD 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 pennit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing[his 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[ime after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in co��formance with the State Building Code.This permit may be <br /> revokef�at any p�r;e for due cause. <br /> j:,` <br /> C�C, �:'f`...�'�-_ C( i f�s' � %� l l <br /> '�pplic'ant�rmrtee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRtBED ABOVE. <br />