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CITY OF ORONO PERMIT NO.: 2010-00659 <br /> 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE �SSVEn: 08/03/2010 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 511 FERNDALE RD N <br /> PIN : 36-118-23-13-0012 <br /> LEGAL DESC : FAIRWAY VIEW <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 1 -WATER CLOSET,2 LAVATORY, 1 BATHTUB, 1 SHOWER <br /> VALUATION OF PLUMBING 6000 <br /> APPLICANT PLUMBING FIXTURE FEE 75.00 <br /> SIGNATURE MECHANICAL INC. STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 8260 ARTHUR STREET NE <br /> SUITE A TOTAL 80.00 <br /> SPRING LAKE PARK, MN 55432- PAID WITH CC# 0300 <br /> (763)788-9844 <br /> OWNER <br /> CAPECE, BARBARA& MARK <br /> 511 FERNDALE RD N <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 additionai 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 I80 days at any time after work has commenced. <br /> The applican[is responsible for assuring all required inspections are <br /> requested in conformance wi[h the Stat Iding Code.This permit may be <br /> revoked a any time for e use. �/i, G C�3J � � / C� <br /> �� � � (/`�- 1�-�-C C'Yy-��.c-2 <br /> 6 / / <br /> App i nt Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />