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3 <br /> CITY OF ORONO PERMIT NO.: 2011-00196 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 04/04/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 2585 OLD BEACH RD <br /> PIN 21-117-23-22-0020 <br /> LEGAL DESC THE MARSH AT LAFAYETTE <br /> LOT 007 BLOCK 001 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: BASEMENT: <br /> 1 WC, I LAV, 1TUB <br /> VALUATION OF PLUMBING 1390 <br /> i <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> PROFESSIONAL PLUMBING SOLUTIONS STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 5730 170TH LANE <br /> RAMSEY,MN 55303- MAIL-IN FEE 2.00 <br /> (763)245-9049 MISC FEE 0.00 <br /> TOTAL 57.00 <br /> PAID WITH CC# 9551 <br /> OWNER <br /> BISHOP,LUZ <br /> 2585 OLD BEACH RD <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 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 <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />