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CITY OF ORONO PERMIT NO.: 2011-00096 <br /> 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- DATE ISSUED: 02/1 U2011 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1185 LOMA LINDA AVE <br /> , PIN : 07-117-23-14-0068 <br /> ' LEGAL DESC : LOMA VALLEY <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <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 MISC FEE 0.00 <br /> TOTAL 22.00 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> WOOLEY, ROBIN&LORI <br /> 1185 LOMA LINDA AVE <br /> MOUND, MN 55364- <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. 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 app(icant 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 /> `�'i�t-�c-c-� �--�, / / / / <br /> Applicant Permitee Signature Date Issued By Sig a ure <br /> � SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABOV . <br /> r <br />