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� , <br /> CITY OF ORONO PERMIT NO.: 200�-00�4� <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUEn: 04/28/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2420 SHADYWOOD RD <br /> PIN : 20-117-23-11-0002 <br /> LEGAL DESC : UNPLATTED 20 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 1 HAND SINK <br /> 1 FLOOR DRAIN <br /> VALUATION OF PLUMBING 5000 <br /> APPLICANT PLUMBING FIXTURE FEE 62.50 <br /> MID-CITY MECHANICAL CORP. STATE SURCHARGE PLBG(VALUATION) 2.50 <br /> 9103 DAVENPORT STREET NE <br /> BLAINE,MN 55449 MAIL-IN FEE 2.00 <br /> (763)78Cr8617 TOTAL 67.00 <br /> OWNER <br /> CENTERS,VOYAGEUR SERVICE <br /> 2420 SHADYWOOD RD <br /> NAVARRE,MN 55392- <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 /> revoked at any time for due cause. <br /> �;�:�� `� o��'l D � � 8'� O 9 <br /> Applican errr►itee Signa ure Date Is d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />