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CITY OF ORONO � � � ��� � l I l I I 1 II <br /> 2750 KELLEY PARKWAY * 20 1 7 - 0 0 6 <br /> DATE ISSUED: 06/28/22 011 <br /> 7 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1860 WEST FARM RD <br /> PIN : 27-118-23-43-0018 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 019 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(MOUND) <br /> NOTE: (3) 1,000 PRECAST CONCRETE TANKS <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> HAYES&SONS EXC. INC. TOTAL 400.00 <br /> Payment(s) <br /> 263 82ND STREET S.E. <br /> CREDIT CARD 5293 400.00 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#: sept-L640 <br /> OWNER <br /> BELTRAND,MARK R&ELIZABETH Y <br /> 1860 WEST FARM RD <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 an t.i' for. -ca .e. <br /> .� '2- 7 pe/ 8 17 <br /> Applicant 'ermitee S gr re Date Issued B ignature Date <br />