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CITY OF ORONO * 2 0 1 7 - PJ 0 2 5 3 * <br />� � 2750 KELLEY PARKWAY DATE ISSUED: 03/17/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1975 FAGERNESS POINT RD <br /> PIN : 18-117-23-14-0006 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 005 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) 025 <br /> MN PLUMBING&APPLIANCE INC. MAIL-IN FEE 2.00 <br /> 14105 RUTGERS STREET NE <br /> PR[OR LAKE, MN 55372- TOTAL 52.25 <br /> (952)469-8341 Payment(s) <br /> Minnesota State License#: cont-58455-PM CHECK 8616 52.25 <br /> OWNER <br /> JOHN& SUSAN PURDY TRSTS <br /> 1975 FAGERNESS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIYD SWORN STATEMENT <br /> I'he work for which this permit is issued shall be perfonned according ro <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only thc 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 time atter 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 /> � � �) 0 �J , ��7, �� <br /> Applicant Permitee Signature Date Issued Signature Date <br />