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CITY OF ORONO * Z 0 1 3 - 0 1 Z Z 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/07/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDR�,SS : 385 STUBBS BAY RD N <br /> � <br /> P[IV : 32-118-23-31-0001 <br /> LEGAL DESC : UNPLATTED 32 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: (3)PRECAST CONCRETE TANKS <br /> 1,000 GALLONS EACH <br /> MOUND TREATMENT SYSTEM-380 SQUARE FEET <br /> �. <br /> APPLICANT SEPT[C NEW OR REPLACEMENT 200.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> HAYES& SONS EXC. INC. MISC FEE 0.00 <br /> 263 82ND STREET S.E. <br /> MONTROSE, MN 55303- TOTAL 205.00 <br /> (763)479-1762 Payment(s) <br /> Minnesota State License#: L640 CREDIT CARD 5293 205.00 <br /> OWNER <br /> CESSOR-CULVER, DEREK& BRIDGET <br /> 385 STUBBS BAY RD N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perforrned 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 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 /> / / <br /> Applicant Permitee Signature Date [ssued By Signature Date <br />