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� � CITY OF ORONO PERMIT NO.: 2010-00867 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUE�: 09/20/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1635 CONCORDIA ST <br /> PIN : 17-117-23-22-0040 <br /> LEGAL DESC : REG. LAND SURVEY NO. ]628 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATI;R SOFTENGR <br /> APPLICANT pLUMB[NG 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 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 22.00 <br /> PAID W[TH CC# 0597 <br /> OWNER <br /> ALTON, LISA <br /> 1635 CONCORDIA ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORIY STATEMEIVT <br /> The work for which this permit is issued shall be performcd according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. "I his permit is for only the work described and does <br /> not grant permission for additional or rclated work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specitied 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 l80 days at any time atter 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 c•use. <br /> �v�'.�c�� 9 �7�� /o �� �3o�/e <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />