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1 <br /> . � <br /> CITY OF ORONO * Z 0 1 6 - PJ 1 5 4 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/19/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 70 FERNDALE GREEN <br /> PIN : 36-118-23-44-0007 <br /> LEGAL DESC : ALLO-RAE TERRACE <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER REPLACEMENT <br /> VALUATION OF PLUMBING 2000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.00 <br /> CHAMPION PLUMBING LLC MAIL-IN FEE 2.00 <br /> 3670 DODD ROAD-SUITE 100 <br /> EAGAN, MN 55123- TOTAL 53.00 <br /> �� Payment(s) <br /> Minnesota State License#: plbg-PC000308,mech-MB005365 CHECK 33807 53.00 <br /> OWNER <br /> BELLINI,CHRISTOPHER&KELLY <br /> 70 FERNDALE GREEN <br /> WAYZATA, MN 55391- <br /> AGREEMEIVT 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 oniy 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 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time afrer 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 /> � l� � l- � UV l ��� l �� <br /> C � � <br /> Applicant Permitee Signature Date Issued B S'gnawre Date <br />