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1 r , <br /> CITY OF ORONO PERMIT NO.: 2010-00911 <br /> ' 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISS[1Ev: 09/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2195 FRENCH LAKE RD <br /> PIN : 10-117-23-21-0006 <br /> LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOTE: WATER SOFTENER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 <br /> 13 Li DANITA CR. <br /> SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-4803 TOTAL 22.00 <br /> Minnesota State License#: 057209PM <br /> OWNER <br /> GOTTSCHALK, ANDREW& ERIN <br /> 2195 FRENCH LAKE RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> i�he work for which this permrt is issued shali be perfomled according to <br /> the approved plans and specifications,appGcable 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 specitied herein.This pennit 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 applican[is responsible for assuring all reyuired inspections are <br /> requested in conformance wi[h the State E3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> ��C�.i.�� �� ��/o d�;�C�-ui � �%/l� <br /> Applicant Permitec Signature Date Iss I3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />