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• CITY OF ORONO PERMIT NO.: 2010-00760 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 08/24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2400 FOX ST <br /> PIN : 04-117-23-41-0011 <br /> LEGAL DESC : MAJESTIC SPRUCE ADDITION <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : PLUMBING (> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 1 WATER SOF"tNF,R <br /> 5 II20N FIL"1'I;RS <br /> l REVERSE OSMOS[S <br /> VALUATION OF PLUMBING 21000 <br /> APPL[CANT PLUMBING FIXTURE FEE 262.50 <br /> CLEARWATER SYSTEMS, INC. STATE SURCHARGE PLBG (VALUATION) 10.50 <br /> 1519 148TH AVE NW <br /> ANDOVER, MN 55304 TOTAL 273.00 <br /> (763)434-0445 <br /> Minnesota State License#: 61240 <br /> OWNER <br /> LINDBLOOM, JULIE <br /> 2690 RAINEY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his permi[is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. '�his permit is for only the�vork described and docs <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of la�tis and ordinances governing this type of work <br /> shall be compied with whether or not speciticd herein."I�his 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 tor a period of 180 days at any time atter work has commenced. <br /> The applicant is sponsible fqr assuring all required inspections are <br /> request i�nformance w h the State Building Code.This permit may be <br /> revo� 't y ti "for 't�cause. r , <br /> / L <br /> f� / (.�� <br /> i C5-iYK-�-,�� l l <br /> ican � ee Sig ure ate Issue y nature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER HAN DESCRIBED AB . <br />