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� PERMIT <br /> C'iTY OF ORONO <br /> 2750 Kelley Parkway- PO Box 66 Permit Number: p12025 <br /> Crystal Bay, Minnesota 55323 Permit Type: Fixtures <br /> (952)249-4600 Date Issued: <br /> 5/2/2008 <br /> SITE ADDRESS: 2750 Kelly Ave Unit# <br /> Excelsior,MN 55331 <br /> PID: 21-117-23-23-0038 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Permit Class: Plumbing <br /> Pemut Type: Fixtures Pemut Sub-type(s): Water Heater <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate perrnits required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Permit Fee: $ 15.00 valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> Misc.Fee: $ 1.50 <br /> TOTAL FEE: $ 17.00 <br /> APPLICANT: Champion Pluxnbing LLC OWNER: John Kozar Etal <br /> 3670 Dodd Road-Suite 100 2750 Kelly Ave <br /> Eagan,MN 55123 Excelsior MN 55331 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> ��R-C�Q C�, ���,Y� <br /> APPLICANT PERMITEE SIGNATURE UED BY SIGNATURE <br /> Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 <br />