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t r <br /> CITY OF ORONO * 2 0 1 3 — 0 1 2 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/03/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4395 NORTH SHORE DR <br /> PIN : 07-117-23-43-0018 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK 018 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NO�1'L-;: WATE?R SOFTNGR <br /> APPLICANT PLUMBING F[XTURE FEE(<$500) 15.00 <br /> WATER DOCTORS STATE SURCHARGE PLBG (<$500) 5.00 <br /> 8201 CENTRAL AVENUE <br /> SPRING LAKE PARK, MN 55432- TOTAL 20.00 <br /> (763)286-6243 <br /> OWNER <br /> CORNESS, JOHN & BARBARA <br /> 4395 NORTH SHORE DR <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMF,NT <br /> �fhe work for which this permit is issued shall bc performed accordin�to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1�his permit is for only the work described and does <br /> not grant permission for additional or related work�vhich 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.�i his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 days of the date of issuance,or if construction is <br /> suspendcd for a period of 180 days at any time after work has commenced. <br /> T�he applicant is responsible Yor assuring all required inspections are <br /> requested in confbnnance with the State Quilding Code.This permit may be <br /> revoked at any time for d cause. �'��� <br /> 1`�' <br /> .;,>---� � --`> ;i (�1tc:.11 ' �._ .� ` .. ,�,; ��c�� i i� t_� -;/I j <br /> � App icant xmitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />