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, CITYOFORONO * 2014 - 00869 * <br /> r 2750 KELLF.Y PARKWAY DATE ISSUED: 08/11/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRF,SS : 1937 FAGERNESS POINT RD <br /> PIN : 17-117-23-23-0012 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 020 BLOCK 000 <br /> PERMIT TYPE : PLUMBWG(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 TOTAL 22.00 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 8645 22.00 <br /> OWNER <br /> BOLDENOW, ELL(F. <br /> 1937 FAGERNESS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> "l�he work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and thc <br /> State E3uilding Code. 'I�his permit is for only the work described and does <br /> not grant permission for additional or related work which requires scparate <br /> permits. All provisions of la�cs and ordinances governing this type of work <br /> shall be compied with��fiether or not specitied herein."I'his permit will <br /> expire and become null and void if construction authorized is not <br /> commcnced 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 Statc Building Code.This permit may bc <br /> revoked at any time for due cau�se. <br /> / / <br /> Applicant Permitee Signature Date Issued By S� ature Datc <br />