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CITY OF ORONO PERMIT NO.: 2011-00226 <br /> , 2750 KELLEY PARKWAY <br /> � <br /> ORONO, MN 55356- DATE ISSUED: 04/19/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1695 FOX ST <br /> PIN : 03-117-23-44-0003 <br /> LECAL DESC : HANSER ADDN <br /> : LOT 001 BLOCI< 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> � CONSTRUCTION TYPE : WATER HEATER <br /> � <br /> � <br /> f <br /> b <br /> k <br /> f <br /> � <br /> � <br /> APPLICANT PLUMBING FIXTURE FEE(<$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 /> O MISC FEE 0.00 <br /> Minnesota State License#: 61770PM TOTAL 22.00 <br /> � OWNER <br /> CATHCART, MR. & MRS. RICHARD <br /> 1695 FOX ST <br /> WAYZATA, MN �5391- <br /> � AGREEMENT AND SWORN STATEMENT <br /> �. <br /> � '1'hc work for which this permit is issucd shall bc performcd according to <br /> ' the approvcd plans and spccitications,applicablc City approvals,and lhc <br /> '[ Statc l3uilding Codc. I�his permit is for only dic work dcscribcd and docs <br /> f not grant permission for additional or rclatcd work which rcquires scparatc <br /> permits. All provisions of la�cs and ordinances governing this type of work <br /> shall be compied�vith���hether or not specitied herein.This permil will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 day�s of the date oC issuance,or if construction is <br /> suspended for a period of 180 days at any time after wark has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confonnance���ith the State Building Code.This permit may be <br /> revoked at any time for duetause. <br /> ��'L'I.�L� � l l l l <br /> � Applicant Permitee Signature Date Issued By Sign �re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER TH N DESCRIBED A E. <br />