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CITY OF ORONO * Z 0 1 7 - 0 0 6 4 9 * <br /> -, 2750 KELLEY PARKWAY DATE ISSUED: 06/14/2017 <br /> � ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3017 NORTH SHORE DR <br /> PIN : 09-117-23-32-0002 <br /> LEGAL DESC : CORONADO BEACH LK MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SPRINKLER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : BACKFLOW DEVICE/TESTING/REPAIR <br /> APPLICANT SPRINKLERS 50.00 <br /> STATE SURCHARGE FLAT-OTHER 1.00 <br /> STEWART PLUMBING,INC. MAIL-IN FEE 2.00 <br /> 13025 GEORGE WEBER DR <br /> SUITE#1 TOTAL 53.00 <br /> ROGERS,MN 55374 Payment(s) <br /> (763)42&1833 CREDIT CARD 3122 51.00 <br /> Minnesota State License#:plbg-PC000474,mech-MB003262 CREDIT CARD 3122 2.00 <br /> OWNER <br /> BLUE,JAMES <br /> 9610 SKY LA <br /> EDEN PRAIRIE,MN 55347- <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 dces <br /> not grant permission for additional or related work which requires separate <br /> pertnits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified hereia 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 Building Code.This permit may be /1,:� <br /> revoked at any time for due cause. �1� <br /> � ,_ . r, <br /> ,,�;� �� � �� � �� �� u �� � � , �y � � <br /> Applicant Permitee Signature ate Issued By ignature Date <br />