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, � CITY OF ORONO PERMIT NO.: 2010-00689 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssvEn: 08/10/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 745 FERNDALE RD N <br /> PIN : 36-118-23-12-0007 <br /> LEGAL DESC : JANET ACRES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENT[AL <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 100 <br /> EAGAN, MN 55123- MAIL-IN FEE 2.00 <br /> (� MISC FEE 0.00 <br /> Minnesota State License#: 61770PM TOTAL 22.00 <br /> OWNER <br /> FREY, KAREN <br /> 745 FERNDALE RD N <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 Ciry approvals,and the <br /> State Building Code. This permit is for only[he work described and does <br /> not grant permission for additional or related work which requires separate <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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �� �� / / i i <br /> Applicant PermiYee Signature Date Issue y g ature a e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB <br />