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� CITY OF ORONO <br /> 2750 KELLEY PARKWAY * Z 0 1 2 - 0 0 1 7 5 * <br /> . DATE ISSUED: 03/07/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1590 LONG LAKE BLVD <br /> PIN : 26-118-23-33-0026 <br /> LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE <br /> : LOT 012 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER SOFTENER <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 TOTAL 22.00 <br /> PAID WITH CC# 0597 <br /> OW1vER <br /> COGBILL,CHARLES&JENNIFER <br /> 1590 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 /> [he 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 sepazate <br /> perrnits. 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 responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoke any time for due cau e. <br /> 3� 7 ��� � �, , � <br /> Applicant Permitee Signature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />