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CITY OF ORONO * z 0 1 z - 0 1 0 3 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 10/15/2012 <br /> ' ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1770 SHADYWOOD RD <br /> PIN : 17-117-23-21-0023 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 018 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 <br /> 1313 DANITA CR. MAIL-IN FEE 2.00 <br /> SHAKOPEE,MN 55379 <br /> (952)445-4803 TOTAL 22.00 <br /> Minnesota State License#:057209PM <br /> OWNER <br /> O'DONOGHUE,DANIEL&SUE <br /> 1770 SHADYWOOD 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 /> �>tiC�C�( LK., � � � � <br /> Applicant Permitee Signature Date Issued By Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />