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� � ,* CITY OF ORONO * z p� 1 5 - 0 0 8 1 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1910 SHORELINE DR <br /> PIN : 10-117-23-42-0017 <br /> LEGAL DESC : REG.LAND SURVEY NO.0096 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLLTMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)BATHTUB,(1)SHOWER,(1)WET BAR <br /> VALUATION OF PLUMBING 4000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 2.00 <br /> GENZ-RYAN PLUMBING&HEAT NIpIL-IN FEE 2.00 <br /> 2200 HIGHWAY 13 <br /> BURNSVILLE,MN 55337 TOTAL 54.00 <br /> (952)767-1000 Payment(s) <br /> CHECK 148062 54.00 <br /> OWNER <br /> &HALIMEH MOUSAVINASAB,MAJID FEHRESTI <br /> 1910 SHORELINE DR <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 Ciry 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 sepazate <br /> permits. 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> 1 U/ l ��l l� <br /> Applicant Perm�tee Signature Date Issue ignature Date <br />