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� . CITY OF ORONO * z 0 1 z - 0 1 1 1 1 * <br /> � <br /> � 2750 KELLEY PARKWAY pATE ►SSUE�: 10/3U2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> RGPRINTGD ON 10/31/2012 <br /> ADDRESS : 3350 FOX ST <br /> PIN : OS-117-23-44-0008 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> � <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> WATER DOCTORS STATE SURCHARGE PLBG (<$500) 5.00 <br /> 8201 CENTRAL AVENUE <br /> SPRING LAKE PARK, MN 55432- TOTAL 20.00 <br /> (763)286-6243 <br /> Minnesota State License#: 082337 <br /> OWNER <br /> BIGOS,NANCY <br /> 3350 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The�cork for which this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction audiorized is not <br /> commenced within ]80 days oY the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter work has commenced. <br /> 1'he applicant is responsible for assuring all required inspections are <br /> requested in confonnance with the$tate Building Code.This permit may be <br /> revoked at any[ime for due�cause. � <br /> �..�'I�t+Q't-Q � i i l i <br /> Applicant Permitee Signature Date Issued By Sign• re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED VE. <br />