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CITY OF ORONO PERMIT NO.: 2011-01426 <br /> `' 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- DATE IssUEn: 1U09/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> REPRINT�D ON 1 1/9/2011 <br /> ADDRESS : 3405 HIGH LA <br /> PIN : OS-117-23-11-0002 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0843 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 1ST FLOOR: 1 WC, 1 LAV, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER <br /> VALUATION OF PLUMBING 2950 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> GLACIER PLUMBING INC STATE SURCHARGE PLBG (VALUAT[ON) 1.48 <br /> 680 VALHALLA DR NE <br /> CEDAR, MN 55011- MAIL-IN FEE 2.00 <br /> (763)413-1883 TOTAL 53.48 <br /> OWNER <br /> REILLY, KEVIN & DENISE <br /> 3405 HIGH LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The�vork 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 permi[will <br /> expire and become null and void if construction authorized is not <br /> commenced widiin 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 /> l_i,•V� � / / l l <br /> l� <br /> Applicant Permitee Signature Date Issued By Signa Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />