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CITY OF ORONO * z 0 1 5 - 0 0 5 2 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/04/2015 <br /> ' ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 761 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0092 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 5 BLOCK 1 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC PAID#2015-00088 04/20/15 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BOLLIG&SONS,INC. STATE SURCHARGE SEWER& WATER 5.00 <br /> 11401 COLTNTY ROAD 3 <br /> HOPKINS,MN TOTAL 105.00 <br /> (612)938-4433 Payment(s) <br /> CREDIT CARD 9081 105.00 <br /> OWNER <br /> Stonebrook Development LLC <br /> 17149 LINCOLN ST NE <br /> #600 <br /> HAM LAKE, MN 55304- <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 goveming 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 /> revoke at any time or due cause. <br /> 1t,d'../ <br /> —� � ' � �'l�'Y�C�c�7 � / �� / lS <br /> pplicant Permitee Signature Date Issued B Signature Date <br />