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., CITY OF ORONO * 2 0 1 5 - 0 0 0 6 7 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OU2U2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3020 NORTH SHORE DR <br /> PIN : 09-117-23-32-0003 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (2)KITCHEN SINKS,(2)DISPOSALS,(1)DISHWASHER <br /> VALUATION OF PLUMBING 8500 <br /> APPLICANT PLUMBING FIXTURE FEE 106.25 <br /> STATE SURCHARGE PLBG(VALUATION) 4.25 <br /> GRABOW PLUMBING,INC. TOTAL 110.50 <br /> 8420 REDWOOD STREET Payment(s) <br /> COON RAPIDS,MN 55433 CHECK 15230 110.50 <br /> 0 <br /> Minnesota State License#:BUIL-038623PM <br /> OWNER <br /> SWENSON,J&K <br /> 3020 NORTH SHORE DR <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. 1'his permit is for only the work described and dces <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming 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 /> comrtenced 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 <br /> revoked at any time for due cause. <br /> v' w -- / ,�2!! � <br /> A plicant Permitee Signature Date Issu By Signature Date <br />