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� CITY OF ORONO * Z 0 1 5 - 0 1 4 3 7 * <br /> 2750 KELLEY PARKWAY �AT� �SSU��: 1U09/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 755 DICKEY LAKE DR <br /> PIN : 34-118-23-22-0009 <br /> LEGAL DESC : RINGERSWOOD <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> APPLICANT PLUMB[NG FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 1.00 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345- TOTAL 18.00 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 8645 18.00 <br /> OWNER <br /> ESAU,TERRANCE&MARY <br /> 755 D[CKEY LAKE DR <br /> LONG LAKE, MN 55356- <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 nuli 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[he State Building Code.This permit may be � <br /> revoked at any time for due cause. �(����� <br /> i i <br /> � � � <br /> � �, �` f �-� �;�,� �; ' � � ,����-� l (i �-( i 1 S <br /> Applicant Permitee Signature Date Issued By Signature Date <br />