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�' CITY OF ORONO <br /> * Z 0 1 5 - 0 0 B 2 0 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 06/24/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 565 FERNDALE RD N <br /> PIN : 36-118-23-14-0004 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMB[NG (<$500) <br /> PROPERTY TYPE : RES[DENT[AL <br /> CONSTRUCT�ON TYPE : WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 5.00 <br /> CULLIGAN SOFT WATER SERV[CE CO. MAIL-[N FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345- TOTAL 22.00 <br /> (952)912-7379 Payment(s) <br /> CRED[T CARD 8645 22.00 <br /> OWNER <br /> LETEUNE,CNARLIE <br /> 565 FERNDALE RD N <br /> WAYZATA, MN 55391- <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. Ali 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 /> � l �.Q..c� � �� C'! � � � Z L <br /> Applicant Permitee Signature Date Issued By Signature Date <br />