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CITY OF ORONO * Z 0 1 6 - 0 PJ 5 5 1 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: OS/19/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3703 CASCO AVE <br /> P[N : 20-117-23-31-0004 <br /> LEGAL DESC : CASCO HEIGHTS <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: REPLACE WATER HEATER <br /> VALUATION OF PLUMBING 0 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.00 <br /> CHAMPION PLUMB[NG 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 32814 53.00 <br /> OWNER <br /> KLICK,JOHN&CYNTHIA <br /> 3703 CASCO AVE <br /> WAYZATA, MN 55391- <br /> AGREEMEfYT 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 nuli 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 �j ,� <br /> revoked at any time for due cause. '/� � ��� <br /> L � I \•�� �� ��� <br /> Applicant Permitee Signature �Date Issued By Si atare Date � <br />