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, ti <br /> CITY OF ORONO PERMIT NO.: 2010-00979 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/1U2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 430 BROWN RD S <br /> PIN : 03-117-23-42-0011 <br /> LEGAL DESC : STRONGHOLD <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOTE: WATBR SOFTENF,R <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 22.00 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> BREHM, EDWARD& KRISTEN <br /> 430 BROWN RD S <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be performed according to <br /> the approved plans and specifications.applicable City approvals,and the <br /> State Building Code. This permi[is for only the work described and does <br /> not grant pennission for additional or related work which requires separate <br /> pemiits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied 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 at any time for due ause. <br /> G� /�� //� /� /� // ��D <br /> A plicant Permitee Signature Date Issue y ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />