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CITY OF ORONO PERMIT NO.: 2011-00376 <br /> 4 -- �� 2750 KELLEY PARKWAY <br /> ? < <� � ORONO, MN 55356- DATE ISSUEn: 05/23/2011 <br /> ; <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2256 SHADYWOOD RD <br /> PIN : 17-117-23-43-0125 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : WATER METER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER METER <br /> NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT. <br /> TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613 <br /> WATER METER RESIDENTIAL 1 <br /> APPLICANT WATER METER RESIDENTIAL 303.70 <br /> MITCH JOHNSEN TOTAL 303.70 <br /> �2184 SHADYWOOD RD <br /> WAYZATA,MN 55391- PAID WITH CC# 4350 <br /> (763)SOCr0629 <br /> OWNER <br /> BURKE,FORREST&RENEE <br /> 2256 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 sepazate <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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />