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CITY OF ORONO PERMIT NO.: 2010-00040 <br /> 2750 KELLEY PARKWAY <br /> , ORONO, MN 55356- DATE ►SSUE�: OU28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 110 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0015 <br /> LEGAL DESC : CREEKSIDE [N ORONO <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : WATER METER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER METER <br /> NOTE: [NSEYC'I'IONS ARE DONE BY PUl3LIC WORKS DGPARTMENT. <br /> TO SET-UP AN INSPEC�I']ON, PLEASG CALL:(9�2)249-4613 <br /> WATER METER RES[DENTIAL HORN 1 WATER METER RESIDENTIAL 1 <br /> APPL[CANT WATER METER RESIDENTIAL 394.67 <br /> SABRE HEATING&AIR COND [NC. WATER METER RESIDENT[AL HORN 104.45 <br /> 3062 RANCHVIEW LN N TOTAL 499.12 <br /> PLYMOUTH, MN 55447 <br /> (763)473-2267 PAID WITH CC# 1 l l l <br /> OWNER <br /> JOHNSON, ANDREW <br /> 4215 TR[LLIUM LN E <br /> MOUND, MN 55�64- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall bc performcd according to <br /> thc approved plans and spccifications,applicablc City approvals,and thc <br /> State Building Codc. This permit is for only the work describcd and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this rype of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction auUiorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspcnded for a period of I 80 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 Cor due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />