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CITY OF ORONO * Z 0 1 6 - 0 0 1 6 5 * <br /> � , , 2750 KELLEY PARKWAY DATE ISSUED: 02/16/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1855 CONCORDIA ST <br /> PIN : 17-117-23-22-0038 <br /> LEGAL DESC : FAGERNESS WOODS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: REPLACE(1)WATER HEATER <br /> VALUATION OF PLUMBING 1500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.75 <br /> BENJAMIN FRANKLIN PLUMBING MAIL-IN FEE 2.00 <br /> 5'718 INTERNATIONAL PKWY <br /> NEW HOPE,MN 55428- TOTAL 52.75 <br /> (612)238-9709 Payment(s) <br /> Minnesota State License#: plbg-PC643703,mech-MB004722 CHECK 24409 52.75 <br /> OW1vER <br /> KELLY, JAMES&MARGARET <br /> 1855 CONCORDIA S. <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 /> 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 I 80 days of the date of issuance,or if construction is <br /> suspended for a period of I80 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 /> � '�O ��`zs�Z a-� /� /�b <br /> Applicant Permitee Signature Date Issued ignature Date <br />