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� � � CITY OF ORONO * z 0 1 z - 0 0 B 8 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/OS/2012 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2425 MAPLE LA <br /> PIN : 33-118-23-44-0021 <br /> LEGAL DESC : DANIELS LONG LAKE HEIGHTS <br /> : LOT 002 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER HEATER <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 /> OWNER <br /> ROTHSTEIN&MEGAN SHINKLE,DAVID <br /> 2425 MAPLE LA <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 dces <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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due ca se. <br /> � `.��Lt�u.t..�r(1 "�1/ Cv l / �. � l � l t 1-_ <br /> Applicant Permitee S�gnature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />