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'• t CITY OF ORONO I I Fit 'III 11 L [ 11' 1F11 <br /> * <br /> 2750 KELLEY PARKWAY * 2 1 8 - 0 0 3 1 <br /> DATE ISSUED: 03/27/22 018 <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 : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> NOTE: WATER SOFTENER <br /> VALUATION OF PLUMBING 2949 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.47 <br /> CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00 <br /> 6030 CULLIGAN WAY <br /> MINNETONKA,MN 55345- TOTAL 53.47 <br /> (952)912-7379 Payment(s) <br /> CREDIT CARD 6828 53.47 <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 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 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 tim for due cause. <br /> a ., 2S, ! • <br /> Applicant Permitee Signature Date Issued B ignature Date <br />