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� ' CITY OF ORONO PERMIT NO.: 2010-00489 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: 06/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4360 SIXTH AVE N <br /> PIN : 31-118-23-12-0011 <br /> LEGAL DESC : SHARON HILLS <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: (3)PRECAST CONCRETE TANKS-SIZE OF TANKS 1,000-MOUND TREATMENT SYSTEM 380 S.F. <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 0.50 <br /> 263 82ND STREET S.E. <br /> MONTROSE,MN 5530� MISC FEE 0.00 <br /> (763)479-1762 TOTAL 200.50 <br /> Minnesota State License#: 640 PAID WITH CC# 5293 <br /> OWNER <br /> HIBBS, WILLIAM <br /> 4360 SIXTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEME1vT <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 180 days at any time after work has commenced. <br /> Thc 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 ny t e for due cause. <br /> __. . _ _ _.� . /Ze�/�d <br /> --� <br /> pp�ca t Permitee Signature Date <br /> Issued By ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />