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• `° CITY OF ORONO * 2 0 1 4 - 0 1 3 7 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U26/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1700 SHORELINE DR <br /> PIN : 10-117-23-14-0014 <br /> LEGAL DESC : UNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (> $500) <br /> PROPERTY TYPF. : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NO'I'E: PLUMBING FIXTURES: <br /> (1) WATERCLOSET <br /> (1)BATHTUB <br /> (1)SHOWER <br /> (2)LAVA"CORIES <br /> VALUATION OF PLUMBING 3200 <br /> APPLICANT PLUMB[NG FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.60 <br /> NRH PLUMBING INC. TOTAL 51.60 <br /> 6460 153RD LN Payment(s) <br /> RAMSEY, MN 55303- <br /> (6 l2)245-7280 CHECK 4107 5].60 <br /> Minnesota State License#: plbg-067436 PM <br /> OWNER <br /> ETAL, IRWIN JACOBS <br /> 1700 SHORELINE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for which this pennit is issued shall be performed according to <br /> the approved plans and specitications,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 rype 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 l80 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 applican[is responsible for assuring all required inspections am <br /> requested in conformance with th�State Building Code.This permit may be <br /> revoked a[an time for due ca c.�, <br /> i <br /> I ^ �� Z� ��y7/1/t-��. l 2(�l <br /> A plieant Permitee Sig ur Date Issu y Signature Date <br />