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CITY OF ORONO PERMIT NO.: 2011-01043 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/14/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3095 NORTH SHORE DR <br /> PIN : 09-117-23-32-0014 <br /> LEGAL DESC : REG.LAND SURVEY NO. 0670 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SPRINKLER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAWN SPRINKLER <br /> NOTE: SPRINKLERS: <br /> HLTNTER 120 <br /> RAINBIRD 1800 <br /> APPLICANT SPRINKLERS 3 5.00 <br /> GREENKEEPER INC. STATE SURCHARGE FLAT-OTHER 5.00 <br /> 12325 MINNETONKA BLVD <br /> MINNETONKA,MN 55305 TOTAL 40.00 <br /> (952)546-0436 PAID WITH CC# 8196 <br /> OWNER <br /> SIME,MICHAEL&PAMELA <br /> 1592 MEDINA RD <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.l'his 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 cause. <br /> � ��-, 9� i�/ � �� � � � ! / <br /> Applicant Permitee Signature Date Issue Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />