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CITY OF ORONO * 2 0 1 4 - 0 0 Z 3 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 03/24/2014 <br /> ORONO, MN 55356- <br /> ` 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3701 LIVINGSTON AVE <br /> PIN : 17-117-23-34-0072 <br /> LEGAL DESC : LAKE MINNETONKA WOODS <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(<$500) � <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 5.00 <br /> CHAMPION PLUMBING LLC MAIL-IN FEE 2.00 <br /> 3670 DODD ROAD- SUITE 100 <br /> EAGAN,MN 55123- TOTAL 22.00 <br /> �) Payment(s) <br /> CHECK 28675 22.00 <br /> OWNER <br /> THAO KIM NGUYEN,TU M LU& <br /> 3701 LIVINGSTON AVE <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 /> � ` <br /> / / <br /> Applicant Permitee Signature Date Issued By i ature Date <br />