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, CITY OF ORONO PERMIT NO.: 2oos-oo424 <br /> 2750 KELLEY PARKWAY <br /> `' ORONO, MN 55356- DATE ISSUED: 12/02/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4056 NORTH SHORE DR <br /> PIN : 07-117-23-44-0062 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE � <br /> NOTE: 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 ME1IL-IN FEE 1.50 <br /> (612)473-3297 TOTAL 17.00 <br /> OWNER <br /> MACGIBBON,NANCY <br /> 11500 TIMBERLINE RD <br /> MINNETONKA,MN 55305- <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 Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This pern►it 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 conswction 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time�for due c�use. <br /> {'�� �l � � / / <br /> Applicant Percnitee Signature Date Issued By ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESC ED ABOVE. <br />