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CITY OF ORONO � 0 1 5 - 0 0 7 1 z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 385 STUBBS BAY RD N <br /> PIN : 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 : MOLTND SYSTEM-SEPTIC <br /> NOTE: A SEPTIC PERMIT WAS PICKED UP AND PAID FOR BY HAYES&SONS 10/07/14-PERMIT#2013-01223,BUT WORK WAS <br /> NEVER DONE. NOW THIS CONTRACTOR(ELMER J.PETERSOI�IS GOING TO DO THE WORK. NOTHING HAS CHANGED. HAYES <br /> TO ASK FOR A REFUND. <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> ELMER J.PETERSON COMPANY TOTAL 405.00 <br /> 5921 DAGUE AVE SE Payment(s) <br /> DELANO,MN 55328 CHECK 19380 405.00 <br /> (763)972-2420 <br /> Minnesota State License#:BUIL-219 <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 perFormed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his permit is for only the work described and dces <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 /> 7'he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.'fhis permit may be <br /> revoked at any time for due cause. <br /> __ �-�$-�, ,� , r5 <br /> rrr►rtee Signature Date Issued y ignature Date <br />