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� ' CITY OF ORONO * Z 0 1 5 - 0 0 4 6 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/23/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1860 SHADYWOOD RD <br /> PIN : 17-117-23-24-0018 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOTE: WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 5.00 <br /> ECOWATER MAIL-IN FEE 2.00 <br /> 3208 FIRST STREET S <br /> WAITE PARK,MN 56387- TOTAL 22.00 <br /> (320)251-2505 Payment(s) <br /> Minnesota State License#:plbg-PC643402 CREDIT CARD 3331 22.00 <br /> OWNER <br /> OMLIE,WILLIAM&RHONDA <br /> 1860 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEME1vT <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 additionai or related work which requires separate <br /> permi[s. 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 cause. e �/ <br /> ��y <br /> � <br /> G� � 1��� 6��� ,��� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />