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� CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 8 - PJ 0 PJ 8 0 * <br /> DATE ISSUED: OU23/2018 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2780 SHADYWOOD RD <br /> PIN : 21-117-23-24-0041 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1196 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER <br /> VALUATION OF PLUMBING 2700 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.35 <br /> WELTER&BLAYLOCK INC. <br /> 307 PERSHING AVE.N TOTAL 51.35 <br /> NEW PRAGUE,MN 56071 Payment(s) <br /> Minnesota State License#: plbg-PM65425,mech-7900379583 CREDIT CARD 5704 5135 <br /> OWNER <br /> CARTER, RICHARD&JEANNE <br /> 2780 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additiona►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 afrer 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 t any time for e se � <br /> / J�l�-/ l � <br /> A ic t Permit S' ature Date Issue y Signature Date <br />