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. <br /> � CITY OF ORONO PERMIT NO.: 2010-00635 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: 07/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1810 SHADYWOOD RD <br /> PIN : 17-117-23-21-0027 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 022 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: REPLACE POTABLE WATER SERVICE FROM CURB STOP TO FRONT DOOR <br /> VALUATION OF PLUMBING 0 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> PIPE DREAM PLUMBING INC STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 3026 GARFIELD ST NE TOTAL 55.00 <br /> MINNEAPOL[S,MN 55418- <br /> Minnesota State License#: 63692 PM <br /> OWNER <br /> WCHARDSON,JENNY <br /> 1810 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 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 /> ..----� � �— '� �"� � '� " / / <br /> Applicant I�ermitee Signature Date Issued By gnature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />