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CITY OF ORONO PERMIT NO.: 2011-00150 <br /> . 2750 KELLFY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUED: 03/07/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1980 HERITAGE DR <br /> PIN : 10-117-23-42-0006 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. 356 <br /> : LOT 006 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (<$�00) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEG(<$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 /> Minnesota State License#: 61770PM <br /> OWNER <br /> : DAYTON, MR. & MRS. <br /> 1980 HGRITAGE DR <br /> � WAYZATA, MN 5�391 <br /> AGREEMENT AIYD SWORN STATEMENT <br /> The���ork for which this permit is issued shall be performed accordii�g to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work describcd and docs <br /> not grant permission for additional or rclated work which rcquires separate <br /> pcnniu. All provisions of laws and ordinanccs dovcrning this type of work <br /> shall be compied���ith whether or not specificd herein.This pennit will <br /> expire and become null and void if construclion authorized is not <br /> � commenced��ithin 180 da��s ot�thc datc of issuance,or if construction is <br /> � suspended for a period oC 180 days at any time after work has commenced. <br /> � ']�he applicant is responsible for assuring all required inspcctions are <br /> � requcsted in confonnance���ith the State 13uilding Code.This permit may be <br /> � revoked at any time for di�e cause. <br /> ��� c',�—� / / / / <br /> ,.. Applicant Permitce Signature Date lssued B �, ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />