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CITY OF ORONO I III VIII II INI1111111111111 All <br /> 2750 KELLEY PARKWAY * 20 1 7 - 0 0 1 5 2 <br /> DATE ISSUED: 02/21/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 500 OLD CRYSTAL BAY RD S <br /> PIN : 04-111-23-42-0029 <br /> LEGAL DESC : CRYSTAL BAY RETREAT <br /> : LOT I BLOCK 1 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: NEW FIXTURES:5 WATER CLOETS,7 LAVATORY,2 BATHTUBS,3 SHOWERS, I KITCHEN SINK, 1 DISPOSAL, I <br /> DISHWASHER, <br /> 2 SILLCOCKS, I FLOOR DRAIN, I WASHER, I WATER HEATER, 1 WET BAR <br /> VALUATION OF PLUMBING 20000 <br /> APPLICANT 1 PLUMBING FIXTURE FEE 250.00 <br /> STATE SURCHARGE PLBG(VALUATION) 10.00 <br /> MIKE'S CUSTOM MECHANICAL INC MAIL-IN FEE 2.00 <br /> P.O.BOX 171 <br /> CHAMPLIN,MN 55316- TOTAL 262.00 <br /> (763)568-7148 Payment(s) <br /> Minnesota State License#:plbg-PC6449 CREDIT CARD 1743 262.00 <br /> OWNER ` <br /> MERZ,BRIAN&KATIE <br /> 2412 BLACK LAKE RD <br /> SPRING PARK,MN 55384- <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. Thi$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 or laws and ordinances gov ruing this type of work <br /> shall be compied with whether or not specified here n.This permit will <br /> expire and become null and void if construction au orized 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 afterwork has commenced. <br /> The applicant is responsible for assuring all requireinspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. /}/n <br /> illiCk, C(- (54 g 0 C-t-'—/ r / <br /> Applicant Permitee Signature' Date Issued BySignature Date <br />