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CITY OF ORONO <br /> * 2 P1 1 6 - 0 PJ 7 3 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 787 BOULDER DR <br /> PIN : 33-118-23-11-0132 <br /> LEGAL DESC : STONEBAY <br /> : LOT 7&8 BLOCK 1 <br /> PERMIT TYPE : WATER METER-RESIDENTIAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER METER-RESIDENTIAL <br /> NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT. <br /> TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613 <br /> 5/8"WATER METER <br /> SERIAL NUMBER 68506709 <br /> ERT HIGH# 1540103380 <br /> WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1 <br /> APPLICANT WATER METER RESIDENTIAL 242.65 <br /> WATER METER RESIDENTIAL HORN 82.02 <br /> SCHULTIES PLUMBING TOTAL 324.67 <br /> 1521 94TH LANE NE <br /> BLAINE,MN 55449 Payment(s) <br /> CHECK 33642 324.67 <br /> (651)786-4007 <br /> Minnesota State License#:plbg-PC644177,mech-MB005379 <br /> OWNER <br /> PIERCE FAM TRUST,MARY SUE <br /> 5491 ANDERSON ESTATES RD <br /> MAPLE PLAIN,MN 55359- <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 /> 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 /> 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 /> �� � � <br /> � � -P � � / <br /> Applicant Permitee Signature Date [ssued B ignature Date <br />