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CITY OF ORONO PERMIT NO.: 2010-01215 <br /> } '" 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/30/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2943 FARVIEW LA <br /> PI N : 04-I 17-23-34-0008 <br /> LEGAL DESC : FARVIEW <br /> : LOT 008 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOT'E: MISCELLANEOUS FIXTURE-REVERSIS OSMOSIS <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CLEARWATER SYSTEMS, INC. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 1519 148TH AVE NW TOTAL 20.00 <br /> ANDOVER, MN 55304 <br /> (763)434-0445 <br /> Minnesota State License#: 61240 <br /> OWNER <br /> WILSON & TARA SULTON, GARY <br /> 2943 FARVIEW LA <br /> LONG LAKE, MN 55356- <br /> AGRF.EMENT AIYD SWORN STATEMENT <br /> 1'he work Ibr which this permit is issucd shall be performed according to <br /> the approvcd plans and speci�ications,applicable City approvals,and the <br /> S[ate Building Code. This permit is Cor only the work described and does <br /> not grant permission for additional or related work���hich requires separate <br /> permits. All pro��isions of la�vs and ordinances�oveming this type oCwork <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced���ithin l80 days of the date of issuanee,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 /> requesled i co mance wilh the Stale}3uilding Code.This permit may be <br /> revo e t a ti��ic f�due cause. <br /> ' r <br /> %���`�_ z <br /> / � /�� �/ ..1��/� <br /> ' plic 'ermitec Signature Date Issu y Signature Date <br /> � SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />