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, . R <br /> CITY OF ORONO * Z 0 1 3 - 0 1 2 9 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/16/2013 <br /> ORONO, MN 55356- <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 : REPAIR <br /> NOTE: SYSTEM WAS INSTALLED THREE YEARS AGO-NOW IS BEING CONNECTED TO HOUSE. <br /> APPLICANT SEPTIC REPAIR 100.00 <br /> MAIL-IN FEE 2.00 <br /> CLASSIC CONSTRUCTION STATE SURCHARGE SEPTIC 5.00 <br /> 18542 ULYSSES STREET NE <br /> EAST BETHEL, MN 55011- TOTAL 107.00 <br /> Minnesota State License#: sept-PB644393 Payment(s) <br /> CREDIT CARD 8654 107.00 <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 goveming 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 I80 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 cau e. <br /> � l ,� �1���..� �.2,c,/lv i/_3 <br /> App icant Permite ure D Iss d By Signature Date <br />