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- � CITY OF ORONO <br /> * 2 PJ 1 2 - 0 0 3 6 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OS/03/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3190 SUSSEX RD <br /> PIN : 04-117-23-32-0007 <br /> LEGAL DESC : FOX BEND <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TY E : RESIDENTIAL <br /> CONSTRUCTI N TYPE : WATER SOFTNER <br /> � <br /> � <br /> � <br /> APPLICAI�TT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> RICHARD'S C STOM WATER STATE SURCHARGE PLBG(<$500) 5.00 <br /> 6121 EXCELSI R BLVD.#206 <br /> ST. LOUIS PA K, MN 55416- TOTAL 20.00 <br /> (952)920-1200 <br /> Minnesota Stat License#: WM061456 <br /> OWIVER <br /> KENNEY,JO N& MARY <br /> 3190 SUSSEX <br /> LONG LAKE, 55356- <br /> AGREE ENT AND SWORN STATEMENT <br /> The work for whi h this permit is issued shall be performed according to <br /> the approved plan and specifications,applicable City approvals,and the <br /> State Building Co e. This permit is for only the work described and does <br /> not grant permiss' n for additional or related work which requires separate <br /> permits. All prov sions of laws and ordinances governing this type of work <br /> shall be compied ith whether or not specified herein.This permit will <br /> expire and beco null and void if construction authorized is not <br /> commenced with 180 days of the date of issuance,or if construction is <br /> suspended for a p riod of 180 days at any time after work has commenced. <br /> The applicant is r s sible for assuring all required inspections are <br /> requested in c ance with the State Building Code.This permit may be <br /> revoked n i e for d ca <br /> _ o�'� 03 , � � <br /> i i <br /> Applicant Per itee S' nature Date Issued By " nature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />