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� ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 4 - 0 1 3 6 0 * <br /> DATE ISSUED: 1U21/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2935 FARVIEW LA <br /> PIN : 04-117-23-34-0009 <br /> LEGAL DESC : FARVIEW <br /> : LOT 009 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> 'JC)"I�E: WATF,R SOP'TI:N�;R <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CROIX CRYSTAL STATE SURCHARGE PLBG (<$500) 5.00 <br /> 3440 YOERG DR MAIL-IN FEE 2.00 <br /> HUDSON, WI 54016- TOTAL 22.00 <br /> (715)386-8667 Payment(s) <br /> CHECK 13086 22.00 <br /> OWNER <br /> BILLIGMEIER, SHIRLEY <br /> 2935 FARVIEW LA <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. 'I'his permi[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 goveming this type of work <br /> shall be compied with whether or not specitied 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 timc a�tcr work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requcsted in conformance with the State E3uilding Code.This permi[ma��bc <br /> revoked at any time for due cause. <br /> �2 ,� <br /> Applicant Permitee Sign� re D' c Issu� By Signature Date <br />