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• � CITY OF ORONO * Z 0 1 5 - 0 0 5 7 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/1U2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2605 KELLY AVE <br /> PIN : 20-117-23-14-0022 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 005 BLOCK 005 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <br /> VALUATION OF PLUMBING 7067 <br /> APPLICANT PLUMBING FIXTURE FEE 8834 <br /> STATE SURCHARGE PLBG(VALUATION) 3.53 <br /> HAFERMAN WATER COND INC. MAIL-IN FEE 2.00 <br /> 12142 12TH AVE S <br /> BURNSVILLE, MN 55337 TOTAL 93.87 <br /> (952)894-4040 Payment(s) <br /> Minnesota State License#: BUIL-WI50110738 CHECK 17906 93.87 <br /> OWNER <br /> WINE, SCOTT&JILL <br /> 2605 KELLY AVE <br /> EXCELSIOR, MN 55331- <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 onty 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 permi[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 bc <br /> revoked at any time for due cause. <br /> /�--� � � �-<-- ��l ) ' <br /> i �.! l_%(�-_� ��(��� ��--� �.-ti-����. � i � � i C <br /> Applicant Permi ee Signature Date Issued By Signature Date <br />