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. � <br /> CITY OF ORONO * 2 0 1 4 - 0 1 0 7 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/23/2014 <br /> ORONO, MN 55356- <br /> 952) 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 3655 NORTH SHORE DR <br /> PIIv : 08-117-23-34-0050 <br /> LEGAL DESC : CRYSTAL BEACH <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: WATER CLOSET 3, 4 LAV,3 SHOWER MUTLITPLE FIXTURES <br /> VALUATION OF PLUMBING 8000 <br /> APPLICANT PLUMBING FIXTURE FEE 100.00 <br /> STATE SURCHARGE PLBG(VALUATION) 4.00 <br /> PREFERRED PLUMBING INC MAIL-IN FEE 2.00 <br /> 6400 HIGH POINT TRAIL TOTAL 106.00 <br /> PRIOR LAKE,MN 55372- <br /> (952)447-5761 Payment(s) <br /> CREDIT CARD 7189 106.00 <br /> OWNER <br /> HAGEN,AL&DONNA <br /> 3655 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 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��c�-� �-'--} � �—.a r---- � ,�--�..3 , t <br /> Applicant Permitee Signature Date Issued By Signature Dat <br />