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CITY OF ORONO PERMIT NO.: 2009-00671 <br /> 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE �ssUEn: 10/05/2009 <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 95 HACKBERRY HILL <br /> P[N : 33-118-23-44-0013 <br /> LEGAL DESC : DANIELS LONG LAKE HEIGHTS <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: 1ST FLOOR: 1 WC,2 LAV, 1 TUB, 1 SHOWER, 1 KITCHEN SINK, 1 DISHWASHER, 1 WATER HEATER <br /> VALUATION OF PLUMBING 8300 <br /> APPLICANT PLUMBING FIXTURE FEE 103.75 <br /> SWANSON PLUMBING INC. STATE SURCHARGE PLBG (VALUATION) 4.15 <br /> 16591-351 AVENUE <br /> HAMBURG, MN 55339 MAIL-IN FEE 2.00 <br /> (612)508-9474 MISC FEE 0.00 <br /> TOTAL ]09.90 <br /> OWNER <br /> SULANDER, DUANE <br /> 95 HACKBERRY HILL <br /> LONG LAKE, MN 55356 <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 E3uilding Code. This permit is tor only the work described and does <br /> not grant permission for additional or related work which requires separatc <br /> permi[s. All provisions of laws and ordinances governing this type of work <br /> shall be compied wi[h whether or not specitied 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 construc[ion is <br /> suspended for 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �/ZyLQ'� Lv`' / / (j'7'kQ-►1_ / / <br /> Applicant Permitee Signature Date Issued By S' ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />