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, , � CITY OF ORONO * z 0 1 7 - 0 0 5 6 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/16/2017 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4380 SIXTH AVE N <br /> PIN : 31-118-23-12-0018 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTNITY : SEPTIC(MOLTND) <br /> NOTE: (3)PRECAST CONCRETE 1300 TANKS <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> HAYES&SONS EXC. INC. Payment(s) <br /> 263 82ND STREET S.E. CREDIT CARD 5293 400.00 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#: sept-L640 <br /> OWNER <br /> MICHAEL DEMENGE&KURTIS WOLBECK <br /> 14226 NEBULA ST NE <br /> CIRCLE PINES,MN 55014- <br /> AGREEME1vT 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 l80 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �� ��� I �� � � � , <br /> � , � <br /> Ap icant Permitee ' ature Date Issued B ignature Date <br />