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. CITY OF ORONO * 2 P1 1 2 - fD 0 2 3 7 * <br /> . 2750 KELLEY PARKWAY DATE ISSUEll: 03/29/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 800 BROWN RD S <br /> PIN : 03-117-23-43-0005 <br /> LEGAL DESC : iJNPLATTED 03 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULL[GAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> �9s2�9i2-�3�9 TOTAL 22.00 <br /> PA[D WITH CC# 0597 <br /> OWNER <br /> SHEILA MILLER, LISLE C. VICKERMAN III/ <br /> 800 BROWN RD S <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his perniit is issued shall be perlormed 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 /> pennits. All provisions of laws and ordinances goveming 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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all reyuired inspections are <br /> requested in conformance with the S[ate Building Code.This permit may be <br /> revoked at any time for due cause. <br /> {'t�t'a'`-( L'�. � � '���-�+'� l l <br /> Applicant Permitee Signature Date Issued By S' ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED A VE. <br />