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CITY OF ORONO * Z 0 1 6 - 0 Pl 6 4 1 * <br /> r � 2750 KELLEY PARKWAY DATE ISSUED: 06/06/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2195 FRENCH LAKE RD <br /> PIN : 10-117-23-21-0006 <br /> LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> ACTIVITY , <br /> NOTE: 3 LAV,1 TUB,2 SHOWER, SINK DISPOSAL,DISHWASHER <br /> VALUATION OF PLUMBING 9800 <br /> APPLICANT PLUMBING FIXTURE FEE 122.50 <br /> STATE SURCHARGE PLBG(VALUATION) 4.90 <br /> WELD& SONS PLUMBING CO INC. <br /> 3410 KILMER LANE N MAIL-IN FEE 2.00 <br /> PLYMOUTH,MN 55441- TOTAL 129.40 <br /> (763)475-0296 Payment(s) <br /> Minnesota State License#: plbg-PC646375,mech-MB003315 CREDIT CARD 6763 129.40 <br /> OWNER <br /> DALTON,MICHAEL&JENNIFER <br /> 2195 FRENCH LAKE 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 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 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 at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Bui]ding Code.This permit may be <br /> revoked at ar�y time for due cause. � <br /> ,/'� ' <br /> / <br /> ',.`r�� `-�� i ��_J.��,,��C�J �� � �� ��?� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />