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CITY OF ORONO * 2 0 1 5 - 0 P1 4 7 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/23/2015 <br /> � ORONO, MN 55356- <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRF.SS : 2224 SHADYWOOD RD <br /> PIN : 17-117-23-42-0003 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 1 LAVATORY(UPSTAIRS), 1 LAUNDRY TRAY, 1 WATER HEATER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> NORTH ANOKA PLUMBING MAIL-IN FEE 2.00 <br /> 22590 RUM RIVER BLVD.N.W. <br /> MN 55070- TOTAL 57.00 <br /> (763)753-3373 Payment(s) <br /> Minnesota State License#:plbg-PC642884 CHECK 19331 57.00 <br /> OWNER <br /> GRIFFIN,MARK&SUSANNE <br /> 2224 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 aze <br /> requested in conforrt►ance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> � � �) � �l � a-� / <br /> Applicant Permitee S gn ture Date Issued By Signature Date <br />