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CITY OF ORONO * 2 0 1 4 - Pl 1 3 6 9 * <br /> , , 2750 KELLEY PARKWAY DATE ISSUED: 1U25/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1233 BRIAR ST <br /> PIN : 10-117-23-24-0030 <br /> LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: WA"I��:R SOI�'I�I:NI:It <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CRO1X CRYSTAL <br /> 3440 YOERG DR MAIL-IN FEE 2.00 <br /> HUDSON, WI 54016- TOTAL 22.00 <br /> (715)386-8667 Payment(s) <br /> CHECK 13109 22.00 <br /> OWNER <br /> FRANK,THOMAS& BARBARA <br /> 1233 BRIAR ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> �I�he work for which this permit is issued shall be performcd 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 governing this type of work <br /> shall be compied with whether or not speciYied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenecd 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 conf'ormance with the State Building Code.This permit may be <br /> revoked at any time Cor due cause. <br /> Gc�c-�e // o2�S / // /.ZV l /SG <br /> Applicant Permitee Signaturc Date Iss ed [3v Signature Date <br />