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♦ <br /> � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * z 0 1 3 - 0 1 2 9 7 * <br /> DATE ISSUED: 12/16/2013 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2760 SHADYWOOD RD <br /> PIN : 21-117-23-24-0040 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1196 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: (1)KITCHEN SINK,(2)DISHWASHERS AND(1)DISPOSAL <br /> VALUATION OF PLUMBING 2000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> HILLCOR PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.00 <br /> 53 TERRACE RD NE TOTAL 51.00 <br /> ST MICHAEL,MN 55376- Payment(s) <br /> (763)688-0342 CREDIT CARD 2293 51.00 <br /> Minnesota State License#: BUIL-PC645327 <br /> OWNER <br /> ENGLER,JEFF <br /> 3330 MARTHA LANE <br /> MINNETONKA,MN 55345- <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 onty the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> pertnits. 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 wi[hin 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 respo ible for assuring all required inspections are <br /> requested in con ce with the State Building Code.This pertnit may be <br /> revoked at ' e for ie cause. <br /> � � �� /Z �(o � <br /> pplicant ermitee Signature Dat sued y Signature Date <br />