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€ CITY OF ORONO PERMIT NO.: 2oiaoi2ii <br /> � 2750 KELLEY PARKWAY <br /> ' � ORONO, MN 55356- DATE ISSUED: 12/28/2010 <br /> ' � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2058 SHORELINE DR <br /> PIN : 15-117-23-21-0003 <br /> LEGAL DESC : HARTWOOD <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 2ND FLOOR: 1 WC, 1 BIDET,2 LAV, 1 TUB, l SHOWER <br /> VALUATION OF PLUMBING 4300 <br /> APPLICANT PLUMBING FIXTURE FEE 53.75 <br /> LAKESIDE PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 12469 ZINRAN AVE. MAIL-IN FEE 2.00 <br /> SAVAGE,MN 55378 <br /> (952)894-7600 MISC FEE 0.00 <br /> TOTAL 60.75 <br /> OWNER <br /> TERRY,JOSEPH&KAIMAY <br /> 5109 RIDGE ROAD <br /> MINNEAPOLIS,MN 55402- <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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at an t�ue cause. <br /> ` �' / / / / <br /> Applicant Permitee Signature Date Issued By Si n ture e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO <br />