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. . � CITY OF ORONO * z 0 1 2 - 0 0 4 8 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/OS/2012 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 235 HOLLANDER RD <br /> PIN : 25-118-23-43-0026 <br /> LEGAL DESC : HOLLY ACRES 2ND ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SPRINKLER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAWN SPRINKLER <br /> APPLICANT SPRINKLERS 50.00 <br /> ABLE SPRINKLER STATE SURCHARGE FLAT-OTHER 5.00 <br /> PO BOX TOTAL 55.00 <br /> ELK RIVER,MN 55330- <br /> Minnesota State License#:PCO2639 <br /> OWNER <br /> KELSEY,DAVID&CHERYL <br /> 235 HOLLANDER 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 sepazate <br /> permiu. 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 after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ,�, ..�"`-7 6 � .y� � � <br /> � � <br /> Applicant Permitee Sign re Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />