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� CITY OF ORONO * 2 0 1 4 - 0 0 0 z� <br /> 2750 KELLEY PARKWAY DATE ISSUED: O1/09/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS ; 1179 ELMWOOD AVE <br /> PIN : 07-117-23-14-0030 <br /> LEGAL DESC : SKARP& LINDQUISTS FERNH[LL LA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOT�: WATER SOFTEI�LR <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 TOTAL 22.00 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 9645 22.00 <br /> OWNER <br /> GARLOCK, MR. & MRS. BRUCE <br /> 1179 ELMWOOD AVE <br /> MOUND, MN 55364 <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 /> no[grant pennission 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 specitied herein.This pennit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if construction is <br /> suspcnded fbr a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requestcd in conformance with the State Quilding Code.This permit may be <br /> revoked at any time for due cause. <br /> � � � / / <br /> Applicant Permitee Signa ure ate Issue By Signature Date <br />