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CITY OF ORONO * z p� 1 5 — 0 0 0 2 1 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: OU08/2015 <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 : WATER METER-RESIDENTIAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER METER-RESIDENTIAL <br /> NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT. <br /> TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613 <br /> I"WATER METER <br /> WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1 <br /> APPLICANT WATER METER RESIDENTIAL 392.92 <br /> RIVERSIDE MECHANICAL WATER METER RESIDENTIAL HORN 104.45 <br /> 12460 Z[NRAN AVENUE TOTAL 497.37 <br /> SAVAGE,MN 55378- Payment(s) <br /> Minnesota State License#: plbg-PC644809,mech-MB650157 CHECK 4373 497.37 <br /> OWNER <br /> i;�t; :�? urcn�; <br /> 2"(5U kelley�P���kway 95�_249-4E;U0 <br /> WINE, SCOTT&JILL i�rono MN ,�53�6 <br /> 2587 KELLY AVE ,lan 8, �'015 <br /> EXCELSIOR, MN 55331- Receipt No: 3.012563 <br /> Riverside Mechanical <br /> Nrevious Balance: <br /> .00 <br /> AGREEMENT AND SWORN STATEMENT Sale Of Wtr Mt,ter 497 37 <br /> >_015-OOU21 2605 Keliy Ave <br /> The work for which this permi[is issued shall be performed according to r;n1-39610 <br /> the approved plans and specifications,applicable City approvals,and the Miscel�aneo�is kevenue <br /> State Building Code. This permit is for only the work described and does ay7.,j� <br /> not grant permission for additional or related work which requires separate TOt81: ______ ________ <br /> permits. All provisions of laws and ordinances governing this type of work <br /> Cf ie�k. <br /> shall be compied with whether or not specitied herein.This permi[will ����k Ni�: ,��73 497.37 <br /> expire and become null and void if construction authorized is not PdyOr: <br /> commenced within 180 days of the date of issuance,or if construction is �; ,,...;;;1�� MNr,hdf i 1 Ca 1 <br /> suspended for a period of 180 days at any time after work has commenced. Tot.��, �q,l���� �~;�� A97.37 <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be Cha�� �I,' I�i u i�i���i: � <br /> revoked at any time for due cause. 1 <br /> � <br /> 1 - - �;��." �.zyi -1 � <br /> .� ��-� � �� , , <br /> A licant Permitee Signature Date Issued By Signatur Date <br />