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CITY OF ORONO PERMIT NO.: 2010-00876 <br /> .. 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUED: 09/22/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 650 GANDER RD <br /> PIN : 04-117-23-43-0020 <br /> LEGAL DESC : FOXWOOD 2ND ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMB[NG(<$500) <br /> PROPERTY TYPE : RES[DENT[AL <br /> C01�1STRUCTION TYPE : FIXTURE <br /> NO"CE: UISHWASHER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECT[ONS STATE SURCHARGE PLBG (<$500) 5.00 <br /> 1313 DANITA CR. <br /> SHAKOPEE, MN 55379 MA[L-IN FEE 2.00 <br /> (952)445-4803 MISC FEE 0.00 <br /> Minnesota State License#: 057209PM TOTAL 22.00 <br /> OWNER <br /> TUCKER,JAMES& WHITNEY <br /> 650 GANDER RD <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMEIYT <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 goveming 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[ime 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 bc <br /> revoked at any time for due caust. <br /> ♦ <br /> � � � / / <br /> Applicant Permitee Signature � Date Issued By S� ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />