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. � <br /> CITY OF ORONO PERMIT NO.: 2011-00144 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssUEn: 03/02/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2256 SHADYWOOD RD <br /> PIN : 17-117-23-43-0125 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: (1)WATER CLOSET,(1)LAVATORY,(1)SHOWER,(I)DISHWASHER AND(1)ICE MACHINE <br /> VALUATION OF PLUMBING 2000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> BETZ PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 22667 NOLAN AVE N TOTAL 55.00 <br /> SCANDIA,MN 55073- <br /> (651)245-2455 PAID WITH CC# 5517 <br /> � <br /> OWNER <br /> BURKE,FORREST&RENEE <br /> 2256 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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> rev t any time for due se. <br /> / / � �� / <br /> cant Permitee S gnature Date Iss y Signat Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />