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' CITY OF ORONO <br /> ' 2750 KELLEY PARKWAY * 2 0 1 4 - PJ 0 0 5 7 * <br /> DATE ISSUED: O1/17/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2248 SHADYWOOD RD <br /> PIN : 17-117-23-43-0126 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: 2 FLOOR DRAINS <br /> VALUATION OF PLUMBING 650 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 033 <br /> WESTONKA MECHANICAL INC <br /> 6501 COLJNTY RD 15 TOTAL 50.33 <br /> MOLJND,MN 55364 Payment(s) <br /> (952)472-4966 CHECK 33990 5033 <br /> OWNER <br /> LAGERSTROM,ED <br /> 2248 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 sepazate <br /> permiu. All provisions of laws and ordinances goveming 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 wnformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By nature �o� ,( ` Date <br />