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� <br /> � ' <br /> . CITY OF ORONO * 2 0 1 3 - 0 1 0 9 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/17/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1290 FRENCH CREEK DR <br /> PIN : 10-117-23-32-0011 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : MECHAMCAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: RPZ VALVE FOR 1"BACKFLOW PREVENTER <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> FACILITECH STATE SURCHARGE MECH(<$500) 5.00 <br /> 4350 BAKER ROAD, STE#400 <br /> MINNETONKA, MN 55345- MAIL-IN FEE 2.00 <br /> (952) 829-5227 TOTAL 22.00 <br /> OWNER <br /> JOHNSON, MR. & MRS. <br /> 1290 FRENCH CREEK DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall bc 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 construetion 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 /> /D i /7 i/� /Di / i /.3 <br /> Applicant Permitee Signat Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />