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1111111111 1111 II 111111 II <br /> CITY OF ORONO <br /> * 2013 - 00796 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/14/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1565 FAIRVIEW COTTAGE LA <br /> PIN : 07-117-23-43-9999 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 5 BLOCK 0 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> POPPITZ CONSTRUCTION STATE SURCHARGE SEWER&WATER 5.00 <br /> 3640 EDGEHILL ROAD <br /> CHASKA, MN 55318- TOTAL 55.00 <br /> (612)369-1110 <br /> OWNER <br /> MARY SNYKER BECKER,TIMOTHY BECKER& <br /> 3432 19TH AVE S <br /> MINNEAPOLIS,MN 55413- <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"time or due cause. <br /> / /— / (971/c6Ln <br /> Applican Permitee Signature Date Issul:Y Signature nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />