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CITY OF ORONOI ,'�II II 1111 <br /> * 20 1 3 - 00 1 42 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 03/05/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 665 ORCHARD PARK RD <br /> PIN : 31-118-23-11-0005 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> VALUATION OF PLUMBING 9500 <br /> APPLICANT PLUMBING FIXTURE FEE 118.75 <br /> KA PLUMBING HEATING&COOL INC. STATE SURCHARGE PLBG(VALUATION) 4.75 <br /> 265 CT <br /> 265 CTY RD 110 NORTH <br /> MOUND,MN 55364 TOTAL 123.50 <br /> (952)472-9200 PAID WITH CC# 4682 <br /> Minnesota State License#:060524-PM <br /> OWNER <br /> REYNOLDS,WILLIAM&MOLLIE <br /> 3630 LIVINGSTON AVE <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 attry timefordue cause. <br /> Applicant Permitee Signature• Date Issued By S. ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB•►' E. <br />