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Y CITY OF ORONO * 2 0 1 4 - 0 0 4 9 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/22/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2965 DEER RUN TR <br /> PIN : 04-117-23-24-0012 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 005 BLOCK 004 <br /> PERMIT TYPF, : PLUMBING (<$500) <br /> PROPERTY TYPE : R�SIDENTIAL <br /> CONSTI2UCTION TYPE : FIXTURE <br /> NOT�: WnTER SOI�TENI�R <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-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 /> SWENSON, MICHAEL& CAROL <br /> 2965 DEER RUN TR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I'he 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 Uie�rork described and does <br /> not grant permission for additional or related work which requires separate <br /> pemlits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied herein."fhis permit will <br /> expire and become null and void if construction authorized is no[ <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended fbr a period of 180 days at any time afrer work has commenced. <br /> 1'he applicant is responsible for assuring�II required inspections are <br /> requested in conformance with the State E3uilding Code."I'his permit may bc <br /> revoked a[any time for due cause. <br /> a�c / �- �� � <br /> Applican ermitee Signature ate Issu By Signature Date <br />