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CITY OF ORONO * 2 0 1 Z — 0 0 3 6 3 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OS/03/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3340 GRAHAM H[LL RD <br /> PIN : OS-117-23-11-0012 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 2 <br /> : LOT 4 BLOCK 2 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> RICHARD'S CUSTOM WATER STATE SURCHARGE PLBG (<$500) 5.00 <br /> 6121 EXCELSIOR BLVD. #206 <br /> ST. LOUIS PARK,MN 55416- TOTAL 20.00 <br /> (952)920-1200 <br /> Minnesota State License#: WM061456 <br /> OWNER <br /> MCCARTY, LEROY& LISA <br /> 3340 GRAHAM HILL ROAD <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 speciYications,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 rela[ed work which requires separate <br /> permits. All provisions of laws and ordinances governing[his type of work <br /> shall be compied with whether or not specified herein.This permi[will <br /> expire and become null and void if construction au[horized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time afrer work has commenced. <br /> The applicant is respo ible for assuring all required inspections are <br /> requested in confo ce 'h the Sta[e Building Code.This permit may be <br /> revoked at any m u ca� <br /> �S'/��/ �Z / <br /> Appl' ant Permite ' na e Date Issued B ' gnature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />