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_ .. CITY OF ORONO PERMIT NO.: 2010-01210 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �ssuEn: 12/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRE�S : 1480 GREEN TREES RD <br /> PI N : 1 1-1 17-23-23-0016 <br /> LEGAL DESC : GREEN TREES ON TANAGER LAKE <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (> $500) <br /> PRONERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NO'�E: WATGR HGATGR REPLACEMEN"I' <br /> VALUATION OF PLUM[3ING 1600 <br /> i <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> ADAM'S ON TIME PLBG STATE SURCHARGE PLBG (VALUATION) 5.00 <br /> 13791 JONQUIL LANEN <br /> DAYTON, MN 55327- MAIL-IN FEE 2.00 <br /> (612)205-6060 TOTAL 57.00 <br /> Minnesota State License#: 066818 PAID WITH CC# 9200 <br /> OWNER <br /> PLATOU, CARL& SUSAN <br /> 1480 GREEN TREES RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIYD SWORN STATEMEIYT <br /> The��ork for�chich this pennit is issued shall be performed accordin�to <br /> the approved plans and spcci�ications,applicable City approvals,and the <br /> State Building Code. This pennit is for unly the�vork described and does <br /> not crant permission for additional or rclated work which requires separatc <br /> permits. All provisions of laws and ordinances coverning this type of work <br /> shall be compied with whcUicr or not spcciticd herein."fhis permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I RO days of the date of issuance,or if construction is <br /> suspendcd for a period of I 80 days at any time after work has commenced. <br /> 'Chc applicant is responsible for assuring all required inspections are <br /> requested in conformance with lhe State l3uildinc Code.This permit may bc <br /> revoke�at any time t�>r duc c usc. <br /> � /�i ��i /O �� i g i LU <br /> Applicant Pcrmitce Si naturc Date Issuc y$ignature Datc <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />