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,, CITY OF ORONO PERMIT NO.: 2009-00366 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 5535C- DATE ISSUED: 07/13/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4300 SIXTH AVE N <br /> PIN : 31-118-23-12-0022 <br /> LEGAL DESC : SHARON HILLS <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW � M ��� <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 0.50 <br /> 263 82ND STREET S.E. TOTAL 200.50 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#: 640 <br /> OWNER <br /> GEHRMAN, ROBERT& MARILYN <br /> 4300 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 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 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � —/t-j <br /> ? � /3 �f �� ), � . � / �- l�� c. <br /> � L,.`;'`'-� / / <br /> A�plicant ermitee Signature Date � � � <br /> Issued y ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />