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CITY OF ORONO PERMIT NO.: 2010-00366 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 05/24/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 40 WEAR LA N <br /> PIN : 33-118-23-34-0010 <br /> LEGAL DESC : ROLLING MEADOWS 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> N1ou,nd SyS1-e <br /> NOTE: REPAIR MOUND <br /> APPLICANT SEPTIC REPAIR 100.00 <br /> LEROUX EXCAVATING INC. STATE SURCHARGE SEPTIC 0.50 <br /> 2104 64TH STREET <br /> WHITE BEAR LAKE,MN 55110- MISC FEE 0.00 <br /> Minnesota State License#: L-778 TOTAL 100.50 <br /> OWNER <br /> HOFFMAN,HUGH J <br /> 40 WEAR LA N <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 Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />