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� CITY OF ORONO *2013-00612* <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 07/03/2013 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952 249-4616 <br /> ADDRESS : 1250 ARBOR ST <br /> PIN : 10-117-23-31-0106 <br /> LEGAL DESC : CRYSTAL BAY MINNETONKA <br /> : LOT 0 BLOCK 0 <br /> PERMTT 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) 5.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA,MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 22.00 <br /> PAID WITH CC# 0597 <br /> OWNER <br /> ENGEBRITSON,REGINA <br /> 1250 ARBOR ST <br /> WAYZATA,MN 55391- <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 gant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 ai any time for due c2use. <br /> �� � � � i i <br /> Applicant Permitee Signature Date Issued By gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED . <br />