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CITY OF ORONO <br /> 11111111 j1111111 <br /> * 20 1 6 - 00394 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/19/2016 <br /> i" ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 585 ORCHARD PARK RD <br /> PIN : 31-118-23-14-0001 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> NOTE: REPLACE WATER METER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.25 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA,MN 55345- TOTAL 52.25 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 5107 52.25 <br /> OWNER <br /> THOMAS,DONALL&HENRIETA <br /> 585 ORCHARD PARK RD <br /> LONG LAKE,MN 55356- <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 /> permits. 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 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 be0 <br /> f� <br /> revoked at any time for due cause. <br /> ,6 <br /> Applicant Permitee Signature Date Issued By Signature Date <br />