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CITY OF ORONO * Z 0 1 4 — fd 0 3 9 9 * <br /> , <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/OS/2014 <br /> ORONO, MN 55356- <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2655 NORTH SHORE DR <br /> PIN : 09-117-23-42-0001 <br /> LEGAL DESC : UNPLATTED 09 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 1ST FLOOR: 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER,2 SILLCOCKS <br /> 2ND FLOOR: 1 WC, 1 LAV, 1SHOWER, 1 FLOOR DRAIN, 1 WATER HEATER <br /> VALUATION OF PLUMBING 11405 <br /> APPLICANT PLUMBING FIXTURE FEE 142.56 <br /> SPRING PLUMBING LLC STATE SURCHARGE PLBG(VALUATION) 5.70 <br /> 11473 KENYON COURT MAIL-IN FEE 2.00 <br /> BLAINE,MN 55449- TOTAL 150.26 <br /> (763)614-7963 Payment(s) <br /> Minnesota State License#: plbg-066807 PM CHECK 9555 150.26 <br /> OWNER <br /> VAN RIEMSDYK, JAMES <br /> 2655 NORTH SHORE DR <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 sepazate <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 aRer work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> r � <br /> � � <br /> Applicant Permitee Signature Date Issued By gnature te <br />