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� CITY OF ORONO * Z 0 1 3 - 0 1 0 9 8 * <br /> '' 2750 KELLEY PARKWAY DATE ISSUED: 10/18/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4064 NORTH SHORE DR <br /> PIN : 07-117-23-44-0085 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTF,: MOVE KI"CCEIEN SINK <br /> FLOOR DRAlN <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> JANET M OBRIGEWITSCH, DAN H PHIPPS& STATE SURCHARGE PLBG(<$500) 5.00 <br /> 4064 NORTH SHORE DR TOTAL 20.00 <br /> MOUND, MN 55364- <br /> OWNER <br /> JANET M OBRIGEWITSCH,DAN H PHIPPS& <br /> 4064 NORTH SHORE DR <br /> MOUND, MN 55364- <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 /> permi[s. All provisions of laws and ordinances governing 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 0 day f the date of issuance,or if construction is <br /> suspended for a p iod of 180 ays at any time afrer work has commenced. <br /> The applicant ponsible fo assuring all required inspections are <br /> requeste confor ance wi the State Buildi ode.This permi[may be <br /> rev�at any Ci o du cause. � _ <br /> l l ��� (� '��,-�t_/ Y � l l <br /> A plic ermitee ignatu Date Issued By.ig ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE <br />