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CITY OF ORONO PERMIT NO.: 2009-00090 <br /> " 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- DATE ISS[1En: 03/OS/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1951 CONCORDIA ST <br /> PIN : 18-117-23-14-0011 <br /> LEGAL DESC : FAGERNESS <br /> : LOT O10 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER <br /> APPLICANT WATER HEATER 15.00 <br /> CHAMPION PLUMBING LLC STATE SURCHARGE PLBG (<$500) 0.50 <br /> 3670 DODD ROAD-SUITE 100 <br /> EAGAN, MN 55123- MISC FEE 1.50 <br /> () TOTAL 17.00 <br /> Minnesota State License#: 61770PM <br /> OWNER <br /> WALDRON,JOHN& LYNN <br /> 1951 CONCORDIA ST <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 /> S[ate Building Code. This permit is for only the work described and does <br /> no[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 construc[ion 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 S[ate Building Code.This permit may be <br /> revoked a[any time for,due cause. <br /> i��'-"`."' ' LyL l l ���YY�v l l <br /> Applicant Permitee Signature Date Issued By ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRI ABOVE. <br />