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r _ � <br /> CITY OF ORONO * Z 0 1 6 - 0 1 4 7 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U29/2016 <br /> ORONO, MN 55356- <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 <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: WATER CLOSET,LAVATORY,SHOWER,WET BAR <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.25 <br /> JONES, M[CHEAL&NATELE TOTAL S1Z5 <br /> 3186 NORTH SHORE DR Payment(s) <br /> WAYZATA, MN 55391- CHECK 5140 51.25 <br /> O W i�TER <br /> JONES, MICHEAL&NATELE <br /> 3186 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 separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or no[specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 1 SO days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time afrer 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 /> revoked at any time for due cause. <br /> �- �i (� � `Y� ��Z� /� i�i / <br /> � � <br /> ' Nc ermitee Signature Da Issued By ignature Date <br />