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, <br /> CITY OF ORONO * Z 0 1 5 — 0 0 9 7 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/03/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2460 COBBLESTONE CT <br /> PIN : 33-118-23-11-0081 <br /> LEGAL DESC : STONEBAY SIXTH ADDITION <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�ISTRUCTION TYPE : CONNECTION <br /> NOTE: REPLACING WATER SERVICF_L[NE FOR IRRIGATION <br /> APPLICANT WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER& WATER 1.00 <br /> SCHULTIES PLUMBING TOTAL 51.00 <br /> 1521 94TH LANE NE <br /> BLAINE, MN 55449 Payment(s) <br /> (651)786-4007 CHECK 33361 51.00 <br /> Minnesota State License#: plbg-058799PM,mech-MB005379 <br /> OWIVER <br /> Wooddale Builders <br /> 6117 BLUE CIRCLE <br /> SUITE 101 <br /> MINNETONKA, MN 55343- <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 /> Sta[e 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 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 cause. <br /> _-�u� � , � d5 <br /> Applicant Permitee Signature Date Issued Signature Date <br />