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CITY OF ORONO PERMIT NO.: 2011-00504 <br /> -► 2750 KELLEY PARKWAY <br /> , ' ORONO, MN 55356- DATE ISSUED: 06/2U2011 <br /> 952 249-4600 FAX: 952 249-4616 ' <br /> ADDRESS : 3105 NORTH SHORE DR <br /> PIN : 09-117-23-32-0016 <br /> LEGAL DESC : REG. LAND SURVEY NO.0670 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE INSTALLERS OF MN INC. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 16740 IREDALE PATH <br /> LAKEVILLE,MN 55044 MAIL-IN FEE 2.00 <br /> (952)894-8367 MISC FEE 0.00 <br /> TOTAL 22.00 <br /> OWNER <br /> FRAHM,MR.&MRS. <br /> 3105 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. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permiu. 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 /> 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 <br /> revoked at any�ue cause. <br /> �� i i i i <br /> Applicant Permitee Signature Date Issued B igr►ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. <br />