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� CITY OF ORONO * 2 0 1 5 — PJ 0 1 7 3 * <br /> 2750 KELLEY PARKWAY �ATE�ssu��: 02/10/2015 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2040 NORTH SHORE DR <br /> PIN : 10-117-23-31-0002 <br /> LEGAL DESC : LINPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <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 /> ERICKSON, MR.& MRS. <br /> 2040 NORTH SHORE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIYD SWORN STATEMENT <br /> The work for which[his permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and thc <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 separate <br /> permits. AII provisions of laws and ordinances governing this type oPwork <br /> shall be compied with whether or no[specified herein."I'his 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> 1 �,' i ��� <br /> � �' � � -�� � c�i/� 2, ��, /�� <br /> Applicant Permitee Signature Date Issued By Si nature Date <br />