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• � CITY OF ORONO * Z 0 1 5 - 0 0 9 8 3 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: 08/03/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1770 SHADYWOOD RD <br /> PIN : 17-117-23-21-0023 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 018 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER SOFTENER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 1.00 <br /> CROIX CRYSTAL MAIL-IN FEE 2.00 <br /> 3440 YOERG DR <br /> HUDSON, WI 54016- TOTAL 18.00 <br /> (715)386-8667 Payment(s) <br /> CHECK 14070 18.00 <br /> OWNER <br /> O'DONOGHUE, DANIEL&SUE <br /> 1770 SHADYWOOD RD <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 wi[h 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 a[any time after work has commenced. <br /> The applicant is responsible for assuring all cequired inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> .� <br /> ��y1�f��f_� � �-� <br /> Applicant Permitee Signature Date Issued B ignature Date <br />