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CITY OF ORONO * 2 0 1 4 - 0 0 PJ 8 6 * <br /> f 2750 KELLEY PARKWAY DATE ISSUED: OU28/2014 <br /> r ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1261 BRIAR ST <br /> PIN : 10-117-23-31-0042 <br /> LEGAL DESC : CRYSTAL BAY MINNETONKA <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 /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CULLIGAN SOFT WATER SERVICE CO. MA[L-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 TOTAL 22.00 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 8645 22.00 <br /> OWNER <br /> PRINTUP, GARY& LINDA <br /> P.O. BOX 104 <br /> CRYSTAL BAY, MN 55323- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfonned accordin�to <br /> [he approved plans and specifica[ions,applicable City approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission fbr addi[ional 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 applican[is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This pennit may be <br /> revoked at any time for due cause. <br /> `�i���.��1. `/� T `— l l <br /> Applicant Permitee Signature Date Issue�gnature Date <br />