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' � CITY OF ORONO PERMIT NO.: 2009-00408 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 07/14/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 645 FERNDALE RD N <br /> P1N : 36-118-23-11-0032 <br /> LEGAL DESC : N/A <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 0.50 <br /> 6030 CULLIGAN WAY <br /> M[NNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> ' (952)933-7200 TOTAL 17.50 <br /> OWNER <br /> PAGE,THOMAS& MARILYN <br /> 645 FERNDALE RD N <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State 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 /> pennits. 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 l80 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 State Building Code.This permit may be <br /> revoked at any time for c�ue cause. <br /> +��� � � � ��(.�/�`� / / <br /> Applicant Permitee Signature Date Issued By gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED AB E. <br />