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CITY OF ORONOI <br /> 11 1 <br /> * 20 1 7 - 00865 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/27/2017 <br /> ORONO,MN 55356- <br /> i (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 200 WAYZATA BLVD W <br /> PIN : 36-118-23-43-0001 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)LAVATORY <br /> (1)KITCHEN SINK <br /> VALUATION OF PLUMBING 1500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.75 <br /> HORWITZ INC. MAIL-IN FEE 2.00 <br /> 4401 QUEBEC AVE N <br /> NEW HOPE,MN 55428 TOTAL 52.75 <br /> Payment(s) <br /> CHECK 57536 52.75 <br /> OWNER <br /> Wayzata Country Club <br /> 200 WAYZATA BLVD W <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 separate <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 /> 671,,(„Led) ki) Alf - 1' CO 7 /a37/ / 7 <br /> Applicant Permitee Signature Date Issued By •" ature Date <br />