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CITY OF ORONO PERMIT NO.: 2009-00016 <br /> 2750 KELLEY PARKWAY <br /> " ORONO, MN 55356- �ATE �SSUED: OU30/2009 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> REPRINTED ON 1/30/2009 <br /> ADDRESS : 85 FERNDALE RD N <br /> PIN : 36-118-23-44-0005 <br /> LEGAL DESC : ALLO-RAE TERRACE <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : WATER METER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER METER <br /> NOTE: INSEPCTIONS ARE DONE BY PUBL[C WORKS DEPARTMGNT. <br /> TO SET-UP AN INSPECTION, PLEASF CALL:(952)249-4613 <br /> NEW 3/4"WA'1'FR MET�R-(METER LEAKING) SI�RIAL#51547269, F.RT H1GH- 1820811761 <br /> WATER METER RESIDENTIAL 1 <br /> APPLICANT WATER METER RES[DENTIAL 312.40 <br /> CHERMAK, TONY TOTAL 312.40 <br /> 85 FERNDA[,E RD N <br /> WAYZATA, MN 55391 <br /> OWNER <br /> CHERMAK, TONY <br /> 85 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The ti�ork for��hich this permit is issued shall be perfonned according to <br /> thc approved plans and specilications,applicable City approvals,and the <br /> State Building Code. This pcnnit 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 specified herein.This permit will <br /> expire and bccome null and void if construction authorized is not <br /> commenced within 180 days of tl�e date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> "I�he applicant is responsible for assuring all rcquired inspections are <br /> requested in conformance with the State I3uildinc Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issucd 13y S ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DES D ABOVE. <br />