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' " CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 2 - 0 0 3 0 1 * <br /> DATE ISSUED: 04/19/2012 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 225 HOLLANDER RD <br /> PIN : 25-118-23-44-0007 <br /> LEGAL DESC : HOLLY ACRES 2ND ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (1)WATER CLOSET,(2)LAVATORIES,(1)BATHTUB AND(1)SHOWER <br /> VALUATION OF PLUMBING 7500 <br /> APPLICANT PLUMBING FIXTURE FEE 93.75 <br /> SUNDERLAND PLBG INC STATE SURCHARGE PLBG(VALUATION) 3.75 <br /> 24380 RIVER BANK LANE <br /> ISANTI,MN 55040- MISC FEE 0.00 <br /> (763)753-2845 TOTAL 97.50 <br /> OWNER <br /> CLOSE,JILL&LOUIS <br /> 225 HOLLANDER 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 dces <br /> not grant perrnission for additional or related work which requires sepazate <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 ass ring all required inspections are <br /> requested in o formance it ate Building Code.This permit may be <br /> rev ed t y ime for e e <br /> � � � �Z '�i/� �/� <br /> A licant Permitee Signature Date Issue Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />