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CITY OF ORONO PERMIT NO.: 2009-00852 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 11/30/2009 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 865 WINDJAMMER LA <br /> PIN : 07-117-23-12-0028 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 001 BLOCK 001 <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)933-7200 MISC FEE 0.00 <br /> TOTAL 17.50 <br /> OWNER <br /> GILLIS&JULIA NELSON,KEVIN <br /> 865 WINDJAMMER LA <br /> MOUND,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 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 be <br /> revoked at any time for due cause. <br /> 4/( / <br /> Applicant Permitee Signature /Date / Issued t J ignature /ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV:A <br />