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A° CITY OF ORONO * 201S — <br /> 2015 — 0 0 S S S * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/27/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3445 WATERTOWN RD <br /> PIN : 32-118-23-43-0009 <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-EACH 1300 GALLONS <br /> MOUND SYSTEM-630 S.F. <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> HAYES&SONS EXC.INC. TOTAL 405.00 <br /> 263 82ND STREET S.E. Payment(s) <br /> MONTROSE,MN 55303- CREDIT CARD 5293 405.00 <br /> (763)479-1762 <br /> Minnesota State License#:sept-L640 <br /> OWNER <br /> Gordon James <br /> P O BOX 306 <br /> MAPLE PLAIN,MN 55359- <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 /> r a any du ause. <br /> Applicant Pe rtee Signature Date Issue By Signature Date <br />