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' � CITY OF ORONO PERMIT NO.: 2011-01546 <br /> 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- �ATE ISSUED: 12/13/20ll <br /> _ (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTED ON t/4/2012 <br /> ADDRESS : 715 FERNDALE RD N <br /> PIN : 36-118-23-11-0017 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1031 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WA"I'ER SOFTENER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERV[CE CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 6030 CULLIGAN WAY <br /> M[NNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 22.00 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> LYMAN, RICHARD <br /> 715 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> 1�he 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 E3wlding Code. This permit is for only the work described and does ( ,-,; � � � <br /> 4'` <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 specitied herein.This permit will " <br /> expire and become null and void if construction authorized is not i " <br /> commenced 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 responsibie for assuring all required inspections are � <br /> requested in conformance with the State Building Code.This permit may bc <br /> revoked at any time for due cause. '�� <br /> / / � / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />