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CITY OF ORONO PERMIT NO.: 2009-00236 <br /> , 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OS/18/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4060 DAHL RD <br /> PIIY : 07-]17-23-11-0020 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 016 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WA"I�ER SOF�ITIER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> SURGE WATER CONDITIONING STATE SURCHARGE PLBG(<$500) 0.50 <br /> 12201 MINNETONKA BLVD <br /> MINNETONKA, MN 55305- TOTAL 15.50 <br /> (952)938-1880 <br /> OWNER <br /> NEVE, MR& MRS. JAMES <br /> 4060 DAHL RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> 7'he work for which this permit is issued shall be perforn�ed 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 pennission 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 specitied herein."I his 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 tor 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 bc <br /> revoked at any time tor due cause. <br /> �� / / / / <br /> Applicant ermitce Sig tur�e Date Issued B gnature ate <br /> SEPARATE ERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />