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CITY OF ORONO * I 1 II 20 I 111_� I'I 1 I I SII 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/26/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1284 WILDHURST TR <br /> PIN : 07-117-23-31-0026 <br /> LEGAL DESC : WILDHURST TRAIL <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION-PIPE SIZE 4"-PVC MATERIAL <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN SEWER&WATER STATE SURCHARGE SEWER&WATER 1.00 <br /> 864 QUAIL PKWY TOTAL 51.00 <br /> WATERTOWN,MN 55388- Payment(s) <br /> (612)508-9974 CHECK 5573 51.00 <br /> Minnesota State License#: SW-57329MR <br /> OWNER <br /> HANSON,KELLY <br /> 14410 GRENIER ROAD <br /> MINNETONKA,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 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 /> kin <br /> Applicant Per9itee Signature Date Issued B ignature Date <br />