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CITY OF ORONO * z 0 1 3 - 0 P1 0 6 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU28/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 765 FERNDALE RD N <br /> PIN : 36-118-23-I1-0014 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1031 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: RGPLACG(1)DISPOSAL <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> LINN STAR TRANSFER INC. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 9995 W. 69TH STREET <br /> SUITE 101 MAIL-IN FEE 2.00 <br /> EDEN PRAIRIE, MN 55344- TOTAL 22.00 <br /> OWNER <br /> NORGAARDEN,JOSEPH & DEBORAH <br /> 765 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The�vork for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State 13uilding Code. '1'his permit is for only thc work described and does <br /> not grant permission Yor additional or related work which requires separate <br /> pennits. 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 tor a period of 180 davs at any time after work has commenced. <br /> Che 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 cau e. <br /> � / � o2c�� /3 � 1�02 �'ll <br /> Applicant Permitee Signat Date Issu By Signature Date � <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />