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� �`` CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 7 — 0 1 3 2 3 * <br /> DATE ISSUED: 10/16/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: 952)249-4616 <br /> ADDRESS : 1300 SIXTH AVE N <br /> PIN : 26-118-23-31-0004 <br /> LEGAL DESC : LTNPLATTED 26 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> ACTIVITY : SEPTIC(OTHER) <br /> NOTE: SEPTIC REPAIR <br /> APPLICANT SEPTIC REPAIR 100.00 <br /> ROTO ROOTER SERVICES CO. TOTAL 100.00 <br /> Payment(s) <br /> 14530 27TH AVE.N. CREDIT CARD 8714 100.00 <br /> MINNEAPOLIS,MN 55447- <br /> (763)519-3907 <br /> OWNER <br /> COFFINDAFFER,CLARENCE <br /> 1300 SIXTH AVE N <br /> LONG LAKE,MN 55356- <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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and dces <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 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 are <br /> requested in confortnance with the State Building Code.This permit may be � <br /> revoked at any time for due cause. <br /> ���f��/ '� /l� llla //7 <br /> Applicant Permitee Signature D te Issued By ature Date <br />