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� <br /> . CITY OF ORONO * 2 0 1 3 - 0 0 0 1 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: Ol/08/2013 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1790 SHADYWOOD RD <br /> PIN : 17-117-23-21-0025 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 020 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTNER <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 /> () TOTAL 22.00 <br /> OWNER <br /> EHLERS,TROY <br /> 1790 SHADYWOOD RD <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 dces <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 /> ��'�t-�-c--Q �. / / / / <br /> Applicant Permitee Signature Date Issue y ' nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED VE. <br />