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CITY OF ORONO PERMIT NO.: 2009-00522 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUED: 08/26/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4040 DAHL RD <br /> PIN : 07-117-23-11-0021 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 017 BLOCK 001 <br /> PERMIT TYPE : SPRINKLER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAWN SPRINKLER <br /> APPLICANT SPR[NKLERS 35.00 <br /> BERGERSON-CASWELL [NC. STATE SURCHARGE FLAT-OTHER 0.50 <br /> 5115 INDUSTRIAL ST. <br /> MAPLE PLA[N, MN 55359 MISC FEE 0.00 <br /> (763)479-3121 MAIL-IN FEE 1.50 <br /> TOTAL 37.00 <br /> OWNER <br /> LEPPLA, MR&MRS JOHN <br /> 4040 DAHL RD <br /> MOUND, MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> Ihe approved plans and specifications,applicable City approvals,and the <br /> State[3uilding 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 bc compied with whether or no[specified herein.This permit will <br /> expire and become null and void if construc[ion authorized is not <br /> commenced within l80 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 applican[is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked a time for due cause. <br /> i i ���- <br /> pplicant Per ee Signature Date �t � � <br /> Issued By naturc ,�-f3ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED A <br />