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, CITY OF ORONO *�1 6 — 0 1 1 8 9 * <br /> ♦ 2750 KELLEY PARKWAY DATE ISSUED: 09/26/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2024 SHADYWOOD RD <br /> PIN : 17-117-23-31-0011 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 004 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: ADDITIONAL FIXTURES:2 WATER CLOSETS,3 LAVATORY,2 SHOWERS, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER, 1 <br /> LAUNDRY TRAY <br /> VALUATION OF PLUMBING 14204 <br /> APPLICANT PLUMBING FIXTURE FEE 177.55 <br /> RIVERSIDE MECHANICAL STATE SURCHARGE PLBG(VALUATION) 710 <br /> 12460 ZINRAN AVENUE TOTAL 184.65 <br /> SAVAGE,MN 55378- Payment(s) <br /> Minnesota State License#:plbg-PC644809,mech-MB650157 CHECK 5953 184.65 <br /> OWNER <br /> KIEFFER,JOHN&BENJAMIN <br /> 2024 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 dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this typc 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 applic ' "res e�sible for ing all required inspections are <br /> reques in co ance the Sta Building Code.This permit may be <br /> rev ed at time for d cause. /�f�� <br /> , � <br /> �1/)"� <br /> � �� �U C/�-� ��-t..e�C.� `� l Z f.o/ 1 (..v <br /> Applicant Permitee Signature Date Issued By Signature Date <br />