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CITY OF ORONO * 2 0 1 3 - 0 1 z 0 z * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: lvi2/2013 <br /> , <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2525 KELLY AVE <br /> PIN : 20-117-23-11-0022 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 001 BLOCK 005 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1900 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> WESTONKA MECHANICAL INC STATE SURCHARGE PLBG(VALUATION) 0.95 <br /> 6501 COLINTY RD 15 <br /> MOUND,MN 55364 MAIL-IN FEE 2.00 <br /> (952)472-4966 TOTAL 52.95 <br /> PAID WITH CC# 1888 <br /> OWNER <br /> HEIMBACH,K&R <br /> 2525 KELLY AVE <br /> EXCELSIOR,MN 55331 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed acwrding 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 sepazate <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�ull 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for du�cause. <br /> ���Q / / l l <br /> Applicant Permitee Signature Date Issued By S' ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED AB E. <br />