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., CITY OF ORONO PERMIT NO.: 2009-00443 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/28/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1510 GREEN TREES RD <br /> PIN : 11-117-23-23-0015 <br /> LEGAL DESC : GREEN TREES ON TANAGER LAKE <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT WATER HEATER I5.00 <br /> CHAMPION PLUMBING LLC STATE SURCHARGE PLBG (<$500) 0.50 <br /> 3670 DODD ROAD-SUITE 100 <br /> EAGAN,MN 55123- MAIL-IN FEE 2.00 <br /> (� TOTAL 17.50 <br /> Minnesota State License#: 61770PM <br /> OWNER <br /> DANKO, GEORGE&NANCY <br /> 1510 GREEN TREES 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 specitications,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 Iaws and ordinances governing this type of work <br /> shall be compied with whether or not specitied 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 aIl required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time fQr due cause. <br /> ��??�(.Q-�-P �- / / / / <br /> Applicant Permitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. <br />