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-� CITY OF ORONO * z 0 1 7 - 0 0 3 3 5 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 04/25/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2024 SHADYWOOD RD <br /> PIN : 17-117-23-31-0011 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 004 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSE"[',(2)LAVATOIRES,(1)SHOWER <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.25 <br /> ELK RIDGE PLUMBING MAIL-IN FEE 2.00 <br /> 18162 HUDSON STREET NW <br /> ELK RIVER, MN 55330- TOTAL 53.25 <br /> (320)438-0296 Payment(s) <br /> Minnesota State License#: plbg-PC718892 CHECK 30638 53.25 <br /> OWNER <br /> KIEFFER,JOHN& BENJAMIN <br /> 2024 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 specitications,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 rype of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if cons[ruction 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State uilding Code.This permit may be <br /> revoked at an time for due cause. ���� <br /> � � ) i�� ' � � _ <br /> r/ ��. I`_7 <br /> K-(:,'G,���1_ ,'� � .1�rt5�:' / _-_ <> <br /> Applica ermite ignature Date Issued By Sig ature Date <br />