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.� - ";� CITY OF ORONO PERMITNO.: 2oiaoio6i <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssuEn: 10/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1305 SIXTH AVE N � <br /> PIN : 26-118-23-34-0004 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.291 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: PER SCOTT-SEWER CONNECTION FEE FOR THE YEAR 2010 IS$12,210.00 PLUS$2,100.00 FOR SAC <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> RITTER EXCAVATING STATE SURCHARGE SEWER&WATER 5.00 <br /> 7120 VERNON STREET � <br /> ROCKFORD,MN 55373 S.A.C. 2,100.00 <br /> (612)477-5649 TOTAL 2,155.00 <br /> Minnesota State License#: 1921 <br /> OWNER <br /> DAYTON,MARY <br /> 1305 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 does <br /> not grant permission for additional or related work which requires separate <br /> permiu. All provisions of laws and ordinances governing this rype 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� conformance with th State Building Code.This permit may be <br /> revoke a y ' for d e <br /> / / �0� 0/ � <br /> Applicant Permitee S�gnature Date ssue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />