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t <br /> CITY OF ORONO * z 0 1 7 - 0 1 1 4 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/18/2017 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3416 SHORELINE DR <br /> PIN : 17-117-23-43-0098 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 000 BLOCK 006 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)3-COMPARTMENT KITCHEN SINK <br /> (1)MOP SINK <br /> (1)HAND SINK <br /> THIS PERMIT IS FOR 3412 SHORELINE DR-COOKIE CUPS <br /> VALUATION OF PLUMBING 3000 <br /> APPLICAI�IT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.50 <br /> NRH PLUMBING INC. MAIL-IN FEE 2.00 <br /> 8751 162ND LANE NW <br /> ANOKA,MN 55303- TOTAL 53.50 <br /> (612)900-7728 Payment(s) <br /> Minnesota State License#: CREDIT CARD 1366 53.50 <br /> plbg-PC644503,H VAGMB004801 <br /> OWNER <br /> Germ-Tom Partnership <br /> 1107 HAZELTINE BLVD#535 <br /> CHASKA, MN 55318- <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 /> 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. < <br /> ,e�' �� �� /g"�/7 <br /> Applican Permitee Signature Date Iss d Signature Date <br />