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" CITY OF ORONO * 2 PJ 1 3 - 0 0 2 6 7 * <br /> w <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/19/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2050 SHORELINE DR <br /> PIN : 10-117-23-34-0014 <br /> LEGAL DESC : HARTWOOD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�T TYPE : FIXTURES-MULTIPLE <br /> NOTE: BASEMENT: 1 WC,3 LAV, 1 TUB, 1 SHOWER <br /> VALUATION OF PLUMBING 6000 <br /> APPLICANT PLUMBING FIXTURE FEE 75.00 <br /> ALL CITY PLUMBING STATE SURCHARGE PLBG (VALUATION) 3.00 <br /> 8100 COUNTY ROAD 1]0 W TOTAL 78.00 <br /> MOLTND, MN 55364- <br /> (612)817-6731 PAID WITH CC# 1607 <br /> Minnesota State License#: PC643613 <br /> OWNER <br /> KVAMME TRUST(TOM BROSTROM), BERTA <br /> 2050 SHORELINE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> nol grant permission Yor additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at an�time for due cau$ . <br /> � � L� �� y� l � , �� . <br /> ��.1 � � <br /> _---_ . <br /> A plicant Permitee Signa�re Date Issued By S' ture D <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />