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. CITY OF ORONO * Z 0 1 2 - 0 0 8 9 6 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 09/10/2012 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 20 CRYSTAL CREEK RD <br /> PIN : 33-118-23-33-0007 <br /> LEGAL DESC : CRYSTAL CREEK <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : PLUMB[NG(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CHAMPION PLUMBING LLC STATE SURCHARGE PLBG (<$500) 5.00 <br /> 3670 DODD ROAD- SUITE l00 <br /> EAGAN, MN 55123- MAIL-IN FEE 2.00 <br /> �� TOTAL 22.00 <br /> OWNER <br /> GAGNE& STACEY WILSON, STEVE <br /> 20 CRYSTAL CREEK RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORIV STATEMENT <br /> Thc work for which this permit is issued shall be performed according to <br /> the approved plans and spccifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant perniission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type ot�work <br /> shall be compied with whether or not specified herein.'i'his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 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 /> requcsted in conformance with th�State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> `-%�G-(,Gc.�l Gv(, l l l l <br /> Applicant Yermitee Signature Date Issucd By Si • ure Uate <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOV . <br />