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CITY OF ORONO * 2 0 1 4 - 0 1 4 6 5 * <br /> • � 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2014 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1480 SIXTH AVE N <br /> PIN : 26-118-23-32-0008 <br /> LEGAL DESC : DOUGLAS ESTATES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOTE: 1 WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 6030 CULLIGAN WAY MAIL-IN FEE 2.00 <br /> MINNETONKA,MN 55345 TOTAL 22.00 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 8645 22.00 <br /> OWNER <br /> GULBRANDSON,DAN&ERICKA <br /> 1480 SIXTH AVE N <br /> LONG LAKE,MN 55356- <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. 1'his permit is for only the work described and dces <br /> not gant 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 suthorized 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 at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />