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,, . CITY OF ORONO * Z 0 1 6 - 0 1 4 0� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/07/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1885 CONCORDIA ST <br /> PIN : 17-117-23-23-0002 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : WATER METER-RESIDENTIAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER METER-RESIDENTIAL <br /> NOTG: INSEPCTIONS AI2�DONE BY PUBLIC WORKS DEPARTMENT. <br /> TO SET-UP AN [NSPECTION,PLEASF,CALL:(952)249-4613 <br /> I" WATER METER <br /> SER[AL#53591581 <br /> GRT HIGH# 1541626820 <br /> WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1 <br /> APPLICANT WATER METER RESIDENTIAL 372.06 <br /> WATER METEFZ RESIDENTIAL HORN 144.64 <br /> FREEDOM MECHANICAL TOTAL 516.70 <br /> 8382 172ND AVE SE Payment(s) <br /> BECKER,MN 55308- CREDIT CARD 6627 516.70 <br /> (612)363-6190 <br /> Minnesota State License#: mech-004042PM,plbg-PC642836 <br /> OWNER <br /> KAISER, BERNARD&CAROLYN <br /> 2855 PROVIDENCE PLACE <br /> INDEPENDENCE, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pernii[is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and Ihc <br /> State E3uilding Code. This permit is for only the work dcscribed and docs <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing Ihis type of work <br /> shail bc compied widi whether or not specified herein.This permit will <br /> expire and becomc null and��oid iY construction audiorized is not <br /> commenced within l KO 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 /> rcquested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> L� �`,KJ �� 7 r � � l l��V <br /> Applicant Permitee Signature ate Issucd Signature Date <br />