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CITY OF ORONO �i �!1 II 1111 111 <br /> 77 * <br /> 2750 KELLEY PARKWAY * 2 1 7 - 0 0 0 2 <br /> DATE ISSUED: 01/25/201717 <br /> • ORONO,MN 55356- <br /> (95 ) <br /> 5356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 285 OLD CRYSTAL BAY RD N <br /> PIN : 33-118-23-31-0005 <br /> LEGAL DESC : UNPLATTED 33 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING 1 <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> NOTE: REPLACING A"RENTAL"WATER SOFTI4ER <br /> VALUATION OF PLUMBING 200 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.10 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA,MN 55345- TOTAL 52.10 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 5107 52.10 <br /> OWNER <br /> MILLER,CARRIE <br /> 285 OLD CRYSTAL BAY RD N <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed#ccording 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 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 it revoked at any time for due cause. `(i 4 l <br /> fria ( ( (f--- -tsu <br /> Applicant Permitee Signature Data Issued By Signatu Date <br />