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CITY OF ORONO PERMIT NO.: 2010-00524 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/24/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2875 WEAR CIR <br /> PIN : 33-118-23-34-0004 <br /> LEGAL DESC : UNPLATTED 33 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: NEW TANKS AND ADD NEW BLACK DIRT-TIE INTO EXISTING SYSTEM <br /> APPLICANT <br /> SEPTIC REPAIR 100.00 <br /> D. KOWALEKI STATE SURCHARGE SEPTIC 0.50 <br /> 1735 IHRIG SE <br /> BUFFALO,MN 55313- MISC FEE 0.00 <br /> (763)477-6866 TOTAL 100.50 <br /> Minnesota State License#: 150 <br /> OWNER <br /> VAN PATTEN <br /> 2875 WEAR CIR <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 /> rev ed't any time for due cause. <br /> 411. <br /> A.An,i3:**&.14/4/ & / e;?.9/ <br /> Applicant Permitee Signature Date Issued ByEil nature to <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE' HAN DESCRIBED ABO <br />