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CITY OF ORONO PERMIT NO.: 2009-00782 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 11/03/2009 <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 790 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-43-0007 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.229 <br /> : LOT 026 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: BASEMENT: 1 WC, 1 LAV, 1 SHOWER, 1 SILLCOCKS, 1 FLOOR DRAIN, 1 LAUNDRY TRAY <br /> 1ST FLOOR: 1 WC, 1 LAV, 1 BATHTUB, <br /> VALUATION OF PLUMBING 3200 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> R M MECHANICAL STATE SURCHARGE PLBG(VALUATION) 1.60 <br /> 2534 EASTWOOD AVE. SE TOTAL 51.60 <br /> BUFFALO,MN 55313- <br /> (763)682-3390 <br /> Minnesota State License#: 005586PM <br /> OWNER <br /> BAKER,KAREN <br /> 790 OLD CRYSTAL BAY RD S <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 ti for due cause. <br /> � 4- 1) 3 / ©q <br /> Applicant Perm' e ture Date <br /> Issued :y S' ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />