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� . . <br /> CITY OF ORONO * 2 PJ 1 3 - 0 1 3 2 4 * <br /> 2750 KELLEY PARKWAY pATE �SSUE�: 12/3U2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1905 FAGERNESS POINT RD <br /> / <br /> PIN : 17-117-23-23-0008 �„( ��J/�� <br /> LEGAL DESC : FAGERNESS ��Q(� �u� ' <br /> : LOT 017 BLOCK 000 � <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATGR SOFTF,MiR <br /> � <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CULLIGAN SOFT WATER SERVtCE 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 0597 22.00 <br /> OWNER <br /> HIBBS, WILLIAM <br /> 865 FAGERNESS PT RD <br /> INDEPENDENCE, MN 55359 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> Ihe approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not erant permission for additional or related work which requires separate <br /> permi[s. 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 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 /> C � - / 3 /Zi� li /3 <br /> Applicant Permitee Signature Da Issue By Signaturc Date <br />