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1 � <br /> J <br /> �'� CITY OF ORONO <br /> * 2 0 1 6 - 0 1 4 8 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1ll28/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2710 KELLY AVE <br /> p(� : 21-117-23-23-0034 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: DISHWASHER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.35 <br /> MN PLUMBING&APPLIANCE INC. MAIL-IN FEE 2.00 <br /> 14105 RUTGERS STREET NE <br /> PRIOR LAKE, MN 55372- TOTAL 52.35 <br /> (952)469-8341 Payment(s) <br /> Minnesota State License#: cont-58455-PM CHECK 8041 52.35 <br /> OWNER <br /> RESTORATION, ROBIN <br /> 2080 SHORELINE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT A1YD SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <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 l80 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 /> � �0 `�" . � l l i��i lC� <br /> Applicant Permitee Signature Date Issued By gnature Date <br />