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, , <br /> CITY OF ORONO * 2 0 1 4 — 0 0 7 6 9 * <br /> 2750 KELLEY PARKWAY pAT� �ssu��: 07/22/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2032 SHADYWOOD RD <br /> PIN : 17-117-23-�1-0012 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 005 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> NOTE: REPLACE WATGR SOI�"I'[?NI?R <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> ECOWATER STATE SURCHARGE PLBG (<$500) 5.00 <br /> 3208 FIRST STREET S MAIL-IN FEE 2.00 <br /> WAITE PARK, MN 56387- TOTAL 22.00 <br /> (320)251-2505 Payment(s) <br /> CREDIT CARD 3331 22.00 <br /> OWNER <br /> LATTERNER, TIMOTHY& SHERYL <br /> 2032 SHADYWOOD RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> '1'he work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> S[ate 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 specitied hercin.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 cons[ruction 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 /> . "] <br /> � / � ? io3�ic1� <br /> Applicant Permitee Signature Date Issu By Signature Date <br />