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CITY OF ORONO PERMIT NO.: 2011-01115 <br /> . � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �AT� issuEn: 09/26/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3215 GRAHAM H[LL RD <br /> PIN : OS-117-23-14-0066 <br /> LEGAL DESC : GRAHAM HILL PRESERVE <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTG: (1)WATER SOf TGNER AND(1)MISCELLANEOUS PIXTURE-IRON R.H. <br /> VALUATION OF PLUMBING 3000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> CLEARWATER SYSTEMS, INC. STATE SURCHARGE PLBG(VALUATION) 1.50 <br /> 1519 148TH AVE NW <br /> ANDOVER, MN 55304 TOTAL 51.50 <br /> (763)434-0445 <br /> Minnesota State License#: 61240 <br /> OWNER <br /> KORSI, KEITH&AMY <br /> 769 BOULDER DRIVE <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performcd according to <br /> thc approved plans and specifica[ions,applicable City approvals,and the <br /> State E�uilding Code. This pennit is for only the work described and does <br /> not gran[pennission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinanccs aoveming 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 wi[hin I 80 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 applican[i responsible for assuring all required inspections are <br /> reque ed� confom ce�th the State[3uilding Code.This permit may be <br /> re � a at any t� fo ause. <br /> - . � _ � �� �? ,2�,/ <br /> � ppli ee Signature Date Issu y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />