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CITY OF ORONO PERMIT NO.: 200�00�5� <br /> - 2750 KELLEY PARKWAY <br /> � • � ORONO, MN 55356- DATE ISSUED: 08/20/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2625 LYDIARD AVE <br /> PIN : 20-117-23-14-0003 <br /> LEGAL DESC : APPLE HILL <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: <br /> WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> CHAMPION PLUMBING LLC STATE SURCHARGE PLBG(<$500) 0.50 <br /> 3670 DODD ROAD-SUITE 100 <br /> EAGAN,MN 55123 MAIL-IN FEE 1.50 <br /> () TOTAL 17.00 <br /> OWNER <br /> JOHNSON,DAVID&AMBER <br /> 2625 LYDIARD AVE <br /> EXCELSIOR,MN 55331 <br /> AGREEMENT 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 null and void if construction authorized is not <br /> commenced within 1 SO 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 /> requested in confoanance with the State Building Code.This permit may be <br /> revoked at any time for d�e cause' <br /> ��t,ec'`.� !�, i i 8i N i �� <br /> Applicant Permitee Signature Date Issued By ' ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBE ABOVE. <br />