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CITY OF ORONO PERMIT NO.: 200&00334 <br /> ' � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/27/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2000 SHADYWOOD RD <br /> PIN : 17-117-23-31-0001 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> GAVIC&SONS PLUMBING&WATER STATE SURCHARGE PLBG(<$500) O.SO <br /> 12725 NIGHTINGALE ST <br /> COON RAPIDS,MN 5544& MAIL-IN FEE 1.50 <br /> (763)755-6468 TOTAL 17.00 <br /> OWNER <br /> KIRCHNER,ROGER&LUCILLE <br /> 2000 SHADYWOOD RD <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 /> permiu. 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 aze <br /> requested in confortnance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By ' nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRI D ABOVE. <br />