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� , CITY OF ORONO * z 0 1 5 - 0 0 3 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/27/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 375 FERNDALE RD N <br /> PIIY : 36-118-23-41-0003 <br /> LEGAL DESC : LTNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (I)WA'I'ERCLOSET <br /> (1)LAVATORY <br /> (1)SHOWER <br /> VALUATION OF PLUMBING 1850 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.93 <br /> WELD& SONS PLUMBING CO INC. MAIL-IN FEE 2.00 <br /> 3410 KILMER LANE N <br /> PLYMOUTH, MN 55441- TOTAL 52.93 <br /> (763)475-0296 Payment(s) <br /> CREDIT CARD 5676 52.93 <br /> OWNER <br /> CARLSON,MATTHEW& KALEENA <br /> 375 FERNDALE RD N <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 the <br /> State E3uilding Code. This permit is for only the work described and does <br /> no[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 authorized is no[ <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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspec[ions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />