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CITY OF ORONO 'I <br /> * 2017 - 01676 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/28/2017 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1080 TONKAWA RD <br /> PIN : 08-117-23-13-0011 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.217 <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE SEWER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE RE-CONNECT <br /> II <br /> NOTE: SEWER RE-CONNECT <br /> PIPE SIZE 4 INCHES <br /> MATERIAL SCHD 40 AIR TESTED <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> J S STEWART COMPANIES,INC. MAIL-IN FEE 2.00 <br /> 11030 LAMONT AVE NE <br /> HANOVER,MN 55341 Payment(s) TOTAL 53.00 <br /> Minnesota State License#: sept-L703 CHECK 8187 53.00 <br /> I <br /> I <br /> OWNER <br /> AHLERS,DAVID <br /> 1080 TONKAWA RD <br /> ORONO,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 /> M � <br /> /, / <br /> Applicant Permitee Signature Date Issued Signature E5ate <br /> it <br />