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. � <br /> CITY OF ORONO * z 0 1 3 - 0 0 2 0 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/O1/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2765 SHADYWOOD RD <br /> PIN : 21-117-23-24-0060 <br /> LEGAL DESC : REG. LAND SURVEY NO.0415 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER HEATER AND REPLACE LAUNDRY TUB. <br /> VALUATION OF PLUMBING 1500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> PETERS PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.75 <br /> 20455 MAOR ROAD <br /> EXCELSIOR,MN 55331- TOTAL 50.75 <br /> (612)803-5066 <br /> Minnesota State License#: PM093027 <br /> OWNER <br /> RANDGAARD,THOMAS <br /> 1730 KENWOOD PKWY <br /> MINNEAPOLIS,MN 55405- <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 on(y the work described and does <br /> not grant permission for additional or related work which requires sepazate <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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for ue s . <br /> ..- <br /> � �� ip / i3 <br /> Ap ant itee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />