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� CITY OF ORONO * 2 0 1 6 - P1 1 4 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/30/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2413 CARMAN ST <br /> PIN : 20-117-23-12-0011 <br /> LEGAL DESC : NAVARRE <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NO'I'E: (2)WATER CLOSETS,(3)LAVATORIES,(1)BATHTUB,(1)SHOWER,(1)WATER HEATER <br /> VALUATION OF PLUMBING 6500 <br /> APPLICANT PLUMBING FIXTURE FEE 81.25 <br /> STATE SURCHARGE PLBG(VALUATION) 3.25 <br /> LEGEND SERVICES, INC TOTAL 84.50 <br /> 201 N MEDINA ST Payment(s) <br /> P O BOX 382 CHECK 8190 84.50 <br /> LORETTO, MN 55357- <br /> (763)479-5002 <br /> Minnesota State License#: mech-MB005090 <br /> OWNER <br /> BLUTH, PETER <br /> 2413 CARMAN ST <br /> WAYZATA, MN 55391- <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 permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this rype of work <br /> shall be eompied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I RO 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 appiicant 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 /> . <br /> �� �l-3�--l�. � / 1 � �� l� <br /> Applica rmi e Signature Date 'Issued Signature Date <br />