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CITY OF ORONO * 2 0 1 7 - 0 0 5 3 4 * <br /> � „ 2750 KELLEY PARKWAY DATE ISSUED: OS/22/2017 <br /> . ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1175 MOONEY LAKE DR <br /> PIN : 25-118-23-41-0017 <br /> LEGAL DESC : MOONEY LAKE PRESERVE <br /> : LOT 8 BLOCK 1 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: NEW:2 WATER SOFTNER, 1 R.O.,3 IRON FILTERS <br /> VALUATION OF PLUMBING 14000 <br /> APPLICANT PLUMBING FIXTURE FEE 175.00 <br /> CLEARWATER SYSTEMS,INC. STATE SURCHARGE PLBG(VALUATION) 7.00 <br /> 1519 148TH AVE NW TOTAL 182.00 <br /> ANDOVER,MN 55304 Payment(s) <br /> (763)4340445 CHECK 34655 182.00 <br /> Minnesota State License#:plbg-61240 <br /> OWNER <br /> ADELMAN,TIMOTHY <br /> 4545 TRILLIUM DRIVE <br /> MEDINA,MN 55340- <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 dces <br /> not grant permission for additional or related work which requires separate <br /> permiu. 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 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 res nsible for assuring all required inspections aze <br /> requested in con ance with tate Building Code.This permit may be <br /> revokedpt time for suse. /� <br /> ' � 'lC/ <br /> � � � <br /> � `,�-Q�S� 5�/ Z.71 / <br /> icant P i ' ature Date Issued By Signa re Date <br />