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� <br /> � <br /> , CITY OF ORONO * 2 0 1 3 - 0 P1 3 5 3 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: OS/14/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2990 SUSSEX RD <br /> PIN : 04-117-23-31-0020 <br /> LEGAL DESC : FOX BEND <br /> : LOT 3 BLOCK 4 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: 1 LIFT STATION <br /> 1000 TANK <br /> APPLICANT SEPTIC REPAIR 100.00 <br /> SWEDLUND SEPTIC(SEE WILLIE'S COMME STATE SURCHARGE SEPTIC 5.00 <br /> 930 DEER CREEK PARKWAY <br /> BELLE PLAINE, MN 56011 TOTAL 105.00 <br /> 952-657-1034 <br /> Minnesota State License#: 398 <br /> OWNER <br /> KELLY,NSTIN& SUSAN <br /> 2990 SUSSEX RD <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 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 aze <br /> requested in conformance with the State Bu' ng Code.This permit may be <br /> re oked at ime ue c <br /> / / / / <br /> App ' ant Pe itee Signature Date Issued By Sig re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER T N DESCRIBED ABOVE. <br />