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" t' CITY OF ORONO <br /> * 20 15 - 00PJ52 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: O1/20/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1510 GREEN TREES RD <br /> PIN : 11-117-23-23-0015 <br /> LEGAL DESC : GREEN TREES ON TANAGER LAKE <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�T TYPE : FIXTURE <br /> NOTE: WATER SOFTENER REPLACEMENT <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA, MN 55345- TOTAL 22.00 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 8645 22.00 <br /> OWNER <br /> STEVENSON, SCOTT <br /> 1510 GREEN TREES 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 described and does <br /> not grant permission for additional or related work which requires separa[e <br /> permits. All provisions of Iaws 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 a[any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with[he Sta[e Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � <br /> / � �D l/5 <br /> Applicant Permitee Signature Date Issue y Signature Date <br />