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CITY OF ORONO PERMIT NO.: 2009-00870 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/02/2009 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 200 WAYZATA BLVD W <br /> PIN : 36-118-23-43-0001 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: ROBERT DISTEL GROUNDS SUPERVISOR DOING THE WORK <br /> INSTALL 1 PRECAST CONCRETE TANK <br /> HOOKING TO EXISTING DRAINFIELD <br /> ALL COMPONENTS TO BE 50'FROM WELL <br /> APPLICANT SEPTIC REPAIR 100.00 <br /> Wayzata Country Club STATE SURCHARGE SEPTIC 0.50 <br /> 200 WAYZATA BLVD W <br /> WAYZATA,MN 55391- MISC FEE 0.00 <br /> TOTAL 100.50 <br /> OWNER <br /> Wayzata Country Club <br /> 200 WAYZATA BLVD W <br /> WAYZATA, MN 55391- <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..plicant is responsible for assuring all required inspections are <br /> re e,ed,in co ormance with the State Building Code.This permit may be <br /> reg <br /> .k d at any t e for due cause. r, <br /> )1 / 1 / o1 Olx <br /> AI plicant Permi ee Signature Date Is d By Signature late <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />