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� CITY OF ORONO PERMIT NO.: 2010-00016 <br /> ' 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE IssuEn: OUi2/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1280 NORTH ARM DR <br /> PIN : 07-117-23-41-0009 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK 003 <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 /> MINNETONKA,MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 17.50 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> PANCHYSITYN,TIMOTHY&JEAN <br /> 1280 NORTH ARM DR <br /> MOLJND,MN 55364 <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 Ciry 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 /> permits. All provisions of laws and ordinances goveming this rype of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become nuli and void if construction authorized is not <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 responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revok at any time or due cause. <br /> 1 /l /a-l�D/v <br /> Applic t Permi ee Signature Date �/�� �v/� <br /> Is By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />