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CITY OF ORONO * z 0 1 2 - 0 0 9 9 5 * <br /> ' �+'' 2750 KELLEY PARKWAY DATE ISSUED: 10/08/2012 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2760 SHADYWOOD RD <br /> PIN : 21-117-23-24-0040 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1196 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 2ND FLOOR: 1 WC, 1 LAV, 1 SHOWER, 1 WET BAR, 1 STAND PIPE FOR FURNACE DRAIN <br /> VALUATION OF PLUMBING 3400 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> CROCK'S PLUMBING INC. STATE SURCHARGE PLBG(VALUATION) 1.70 <br /> 9037 ARCHER CT <br /> MAPLE GROVE,MN 55311- TOTAL 51.70 <br /> (763)494-9160 PAID WITH CC# 5767 <br /> Minnesota State License#:060723 PM <br /> OWNER <br /> ENGLER,JEFF <br /> 3330 MARTHA LANE <br /> MINNETONKA,MN 55345- <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 conformance with the State Building Code.This permit may be <br /> revoked a y time for du use. <br /> ``� � �� / / <br /> A pli an ermitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABO . <br />