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CITY OF ORONO * 2 0 1 2 — 0 0 1 8 3 * <br /> ' 2750 KELLEY PARKWAY �pTE �ssuE�: 03/12/2012 <br /> ' ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1950 CONCORDIA ST <br /> PIN : 18-117-23-14-0016 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMB[NG FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG (<$500) 5.00 <br /> 1313 DAN[TA CR. <br /> SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-4803 MISC FEE 0.00 <br /> Minnesota State License#: 057209PM TOTAL 22.00 <br /> OWNER <br /> PETERS, WILL[AM & KAREN <br /> 1950 CONCORDIA ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and [he <br /> State[3uilding Code. This permit is for only the work described and does <br /> not gran[permission for additional or rclated work which requires separatc <br /> pemiits. All provisions of laws and ordinances governing this type of work <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 within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requesled in conformance with the State Building Code.This permit may be <br /> revoked at any time for due-cause. <br /> `7'ucL� �-n- l l l l <br /> Applicant Permitee Signature Dale Issued By Sig ure te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRiBED AB E. <br />