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CITY OF ORONO * z 0 1 5 - 0 1 1 7 9 * <br /> " 2750 KELLEY PARKWAY DATE ISSUED: 09/15/2015 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4105 BAYSIDE RD <br /> PIN : 06-117-23-14-0023 <br /> LEGAL DESC : BAYSIDE RIDGE <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 2 KITCHEN SINKS, 1 DISPOSAL& 1 DISHWASHER <br /> VALUATION OF PLUMBING 3500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.75 <br /> PLUMB[NG SERVICES, [NC. TOTAL 51.75 <br /> 7938 NORTH SHORE TRAIL <br /> FOREST LAKE, MN 55025- Payment(s) <br /> Minnesota State License#:plbg-58570PM CREDIT CARD 6738 51.75 <br /> OWNER <br /> BURKE,NICK&SUE <br /> 4105 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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[he 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 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 a[any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> reque ted in conformance with the State Building Code.This permit may be <br /> revok d at any time for due cause. �, ���� <br /> i � � / \ � � `� � I � � �� C � I��f�.-t�C� / J/ �C� <br /> � r �� <br /> Appl ant Permitee Signature Date Issued By Signature Da e <br />