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- CITY OF ORONO PExM�T�vo.: 2010-00321 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: 05/07/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3770 BAYSIDE RD <br /> PIN : OS-117-23-24-0121 <br /> LEGAL DESC : OTTOVILLE ON LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOTE: WATER SOFTENF,R <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 0.50 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 17.50 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> [II, WINF[ELD STEPHENS <br /> 3770 BAYSIDE RD <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 /> S[ate 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 pennit 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 appiicant is responsible for assuring all required inspections are <br /> requested in conformance with[he State Building Code.This permit may be <br /> revoked a[any time for due ca se. <br /> � G(� �l � l /D O �l 7 / /O <br /> Applicant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />