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` CITY OF ORONO PERMIT NO.: 2010-00947 <br /> , 2750 KELLEY PARKWAY <br /> ORONO, MN 5535C- DATE ISSUED: 10/OS/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1509 LONG LAKE BLVD <br /> PIN : 35-118-23-22-0003 <br /> LEGAL DESC : ALBEES LONG LAKE ADDN <br /> : LOT 000 BLOCK 000 <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 /> OWNER <br /> CASHMAN,THOMAS <br /> 1509 LONG LAKE BLVD <br /> LONG LAKE,MN 55356 <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 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 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 responsible for assuring all required inspections aze <br /> requested in wnformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / � / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />