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� � CITY OF ORONO * Z 0 1 3 - P1 0 8 6 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/26/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1290 FRENCH CREEK DR <br /> PIN : 10-117-23-32-0011 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NO"I�E: WA"I-ER SOF"I�ENFR <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345 MAIL-IN FEE 2.00 <br /> (952)912-7379 TOTAL 22.00 <br /> PAID WITH CC# 0597 � <br /> OWNER <br /> JOHNSON, MR. & MRS. <br /> 1290 FRENCH CREEK DR <br /> WAYZATA, MN 5539]- <br /> AGREEMENT AND SWORN STATEMENT <br /> fhe work tbr which this permit is issued shall be peribrmed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 7�his 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 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the Sta Building Code"i�his permit may be <br /> revoked a y time for due cause. <br /> �o�� ! g' ,� ,� <br /> Applicant Permitee Signa Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />