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` ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 6 — 0 0 8 7 4 * <br /> DATE ISSiTED: 07/28/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952 249-4616 <br /> ADDRESS : 3585 SIXTH AVE N <br /> PIN : 29-118-23-43-0004 <br /> LEGAL DESC : LJNPLATTED 29 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(HOLIDING TANKS) <br /> NOTE: 1500 GALLON PRECAST CONCRETE HOLDING TANKS <br /> . APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> SEPTIC CHECK,INC. Payment(s) <br /> 6074 KEYSTONE RD CREDIT CARD 2685 400.00 <br /> MILACA,MN 56353- <br /> (320)630-4253 <br /> Minnesota State License#:sept-2624 ' <br /> OWNER <br /> ANDERSON&DAVID LIND,RICK <br /> 3585 SIXTH AVE N <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pertnit 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.l'his 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 /> (G�I,�L�U�t�-- 7� S-�� � � � i�i/� <br /> Applicant Permitee Signature Date Issued B ignahue Date <br />