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, CITY OF ORONO * Z 0 1 7 - 0 0 6 0 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/OS/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4305 CHIPPEWA LA <br /> PIN : 31-118-23-42-0011 <br /> LEGAL DESC : CHIPPEWA <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.25 <br /> CITY VIEW PLUMBING&HEATING TOTAL 50.25 <br /> 1880-B WAYZATA BLVD W <br /> P.O. BOX 150 Payment(s) <br /> LONG LAKE, MN 55356 CHECK 37064 50.25 <br /> (952)473-8793 <br /> Minnesota State License#:plbg-MB005208 <br /> OWNER <br /> CORNICK,JAMES& DEBRA <br /> 4305 CHIPPEWA LA <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his 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 1 AO days of the date of issuance,or if construction is <br /> suspended for a period of I SO days at any time after work has commenced. <br /> The applicant is responsible for assuring all re ui pections are <br /> requested in conformance with the ui ding Code.This permit may be <br /> revoked at y time for use. <br /> ,� � ' ��� �� �ro � � S �/7 <br /> A ic ermitee Signature Dat ssued By ignature Date <br />