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1111111111111111111111111111 M <br /> CITY OF ORONO * 2014 - 00970 * <br /> f 2750 KELLEY PARKWAY DATE ISSUED: 08/28/2014 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: 952 249-4616 <br /> ADDRESS 1070 TONKAWA RD <br /> PIN 08-117-23-13-0020 <br /> LEGAL DESC RYANWOOD <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE SEWER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> WICKENHAUSER EXC <br /> TOTAL 55.00 <br /> 13650 CO. RD 41 <br /> COLOGNE,MN 55322- Payment(s) <br /> (612)270-7766 CHECK 3490 55.00 <br /> OWNER <br /> SUDDENDORF,MARIAN&JAMES <br /> 1070 TONKAWA 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By ature Date <br />