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CITY OF ORONO � r <br /> 1F 1 11 �i <br /> * <br /> 2750 KELLEY PARKWAY * 2 1 4 - 0 0 5 1 <br /> DATE ISSUED: 06/09/22 014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 850 OLD CRYSTAL BAY RD S <br /> PIN : 09-117-23-12-0005 <br /> LEGAL DESC : FRENCH CREEK WOODS <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: KITCHEN SINK&ICEMAKER <br /> VALUATION OF PLUMBING 750 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.38 <br /> NORTH ANOKA PLUMBING MAIL-IN FEE 2.00 <br /> 22590 RUM RIVER BLVD.N.W. <br /> MN 55070- TOTAL 52.38 <br /> (763)753-3373 Payment(s) <br /> CHECK 18578 52.38 <br /> OWNER <br /> ELLWEIN,MICHEAL&ELIZABETH <br /> 850 OLD CRYSTAL BAY RD S <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 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 /> Applicant Permitee Signature Date Issue By gnature ate <br />