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CITY OF ORONO PERMIT NO.: 2011-01546 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/13/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> REPRINTED ON l/4/2012 <br /> ADDRESS : 715 FERNDALE RD N <br /> PIN : 36-118-23-11-0017 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1031 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: VVATER SOFTENER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 22.00 <br /> PA[D WITH CC# 0597 <br /> OWNER <br /> LYMAN, RICHARD <br /> 715 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 /> [he approved plans and specifications,applicable City approvals,and the <br /> State E3uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separa[e <br /> permits. 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 I 80 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 E3uilding Code.This permit may be <br /> revoked at any time Yor due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRBED ABOVE. <br />