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CITY OF ORONO * 2 0 1 2 - 0 1 0 1 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/09/2012 <br /> ORONO, MN 55356- <br /> `' (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2285 WEBBER HILLS RD <br /> PIN : 03-117-23-33-0003 <br /> LEGAL DESC : WEBBER HILLS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <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 /> () TOTAL 22.00 <br /> OWNER <br /> PEDERSON,D&K <br /> 2285 WEBBER HILLS 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 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 after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with thqtate Building Code.This permit may be <br /> revoked at any time fondue cause. <br /> Applicant Permitee Signature Date Issued It Sid ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED AB E. <br />