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� CITY OF ORONO PERMIT NO.: 20o�-ooss4 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 09/14/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3186 NORTH SHORE DR <br /> PIN : 09-117-23-32-0010 <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: (5)WATER CLOSETS,(6)LAVATORIES,(2)BATHTUBS,(1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL,(1)DISHWASHER,(2) <br /> SILLCOCKS(2)FLOOR DRAINS(2)LAUNDRY TRAYS,(1)WASHER,(1)WATER HEATER,(1)WATER SOFTENER <br /> VALUATION OF PLUMBING 29900 <br /> APPLICANT PLUMBING FIXTURE FEE 373.75 <br /> FREEDOM MECHANICAL STATE SURCHARGE PLBG(VALUATION) 14.95 <br /> 11135 HWY. 7 TOTAL 388.70 <br /> WATERTOWN,MN 55388 <br /> (612)363-6198 <br /> Minnesota State License#:004042PM <br /> OWNER <br /> NEDDERMEYER,GLEN <br /> 709 MINNETONKA HIGHLAND LA <br /> LONG LAKE,MN 55356- <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 /> 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 /> commenced within 180 days of the date of issuance,or if consVuction 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revok ' e for du�/� <br /> � 9//.3 /4 � � l/ lD <br /> Applicant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />