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r � <br /> CITY OF ORONO * 2 0 1 3 - Pl 0 2 2 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/09/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2195 FRENCH LAKE RD <br /> PIN : 10-117-23-21-0006 <br /> LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER SOFTEN�R <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 /> GOTTSCHALK, ANDREW&ERIN <br /> 2195 FRENCH LAKE RD <br /> WAYZATA, MN 55391- <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 describcd and does <br /> not grant permission for additional or related work which req�ires separa[e <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whe[her 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 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 for due cause. <br /> �/�G(�i�-f_Gr--� / � / � �J -- � l � l� <br /> Applicant Permrtee Signature Date � [ss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />