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• <br /> CITY OF ORONO �* 2� 1f 1 11 11 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/16/2014 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2300 WILLOW HILL DR <br /> PIN : 03-117-23-32-0026 <br /> LEGAL DESC : WILLOW HILL <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: (3)PRECAST CEMENT TANKS <br /> MOUND 10 X 63 S.F. <br /> APPLICANT SEPTIC NEW 200.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> BURNS EXCAVATING, INC. TOTAL 205.00 <br /> 3470 CO.RD 21 <br /> MAYER,MN 55360- Payment(s) <br /> (612)685-4303 CHECK 25528 205.00 <br /> Minnesota State License#: SW-1888 <br /> OWNER <br /> Sowada Willow Property LLC <br /> 725 FERNDALE RD N <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 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 /> &,/5/ <br /> Applicant Permitee Signature Date Issue'J:y Signature Date <br />