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� CITY OF ORONO rERM�T�vo.: 2oiaoo690 <br /> • 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuED: 08/10/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1416 BALDUR PARK RD <br /> PIN : 08-117-23-34-0015 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT O11 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: KITCHEN SINK <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 <br /> 1313 DANITA CR. <br /> SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-4803 MISC FEE 0.00 <br /> Minnesota State License#: 057209PM TOTAL 22.00 <br /> OWNER <br /> MARCIA PETERSON,JEFFREY ULKU/ <br /> 1416 BALDUR PARK RD <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 [he <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[his 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 au[horized 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 cesponsible for assuring all required inspections are <br /> req�ested in conformance w�th the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> `%'✓�—� `1, / / / / <br /> Applicant Permitee Signature Date Issue y i nature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED ABO <br />