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CITY OF ORONO II I I III 111 11111111111111 <br /> * 20 1 3 - 0 0 7 87 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/12/2013 <br /> ORONO, MN 55356- <br /> • (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 160 WEAR LA N <br /> PIN : 33-118-23-34-0014 <br /> LEGAL DESC : ROLLING MEADOWS 3RD ADDN <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: 2 WATER HEATERS <br /> VALUATION OF PLUMBING 1600 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(VALUATION) 0.80 <br /> 3670 DODD ROAD- SUITE 100 <br /> EAGAN, MN 55123 MAIL-IN FEE 6.20 <br /> 0 MISC FEE 0.00 <br /> TOTAL 57.00 <br /> OWNER <br /> HELLING, MATTHEW&CAROLINE <br /> 160 WEAR LA N <br /> LONG LAKE,MN 55356 <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 time for due•cause. <br /> LiZ4GL <br /> Applicant Permitee Signature Date Issued By ignature ."" Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A:&VE. <br />