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CITY OF ORONO PERMIT NO.: 2011-015G7 <br /> , 2750 KELLEY PARKWAY <br /> , ORONO, MN 55356- DATE rsSUED: 12/19/2011 <br /> (952) 249-4600 FAX: (9�2) 249-4616 <br /> ADDRESS : ll05 BROWN RD S <br /> PIN : 10-117-23-24-0004 <br /> LEGAL DESC : UNPLATTED 10 ]17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIV TYPE : WATER SOFTNER <br /> I <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 MATL-IN FEE 2.00 <br /> (952)912-7379 MISC FEE 0.00 <br /> TOTAL 22.00 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> CHRISTENSON, JERRY <br /> 1 105 BROWN RD S <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> � The work for wi�aci�this permit is issued shall be performed according to <br /> i the approved plans and specificanons,applicable City approvais,and [he <br /> State Building Code. This pennit is for only the work descrfbed and does <br /> not grant permission for additional or rela[ed 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 I <br /> suspended for a period of 180 days at any time after work has commenced. � <br /> The applicant is responsible for assuring all reyuued inspections are <br /> requested in conformance with the Sta[e Building Code.This permit may be <br /> revoked at any time for due cause� <br /> �l��.�-�- (�- � � , � <br /> � Applicant Yermitee Signature Date Issued By ign re ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER TH N DESCR]BED AB E. <br />