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� ! CITY OF ORONO <br /> � * 2 0 1 5 - 0 0 8 9 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/20/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 809 BROWN RD N <br /> PIN : 27-118-23-34-0006 <br /> LEGAL DESC : LTNPLATTED 27 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�TSTRUCTiON TYPE : CONNECTION <br /> NOTE: STORM SEWER CONNECTION TO MANHOLE. TRACER WIRE INTO MANHOLE. <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER& WATER 1.00 <br /> BOLLIG& SONS, INC. TOTAL 51.00 <br /> 11401 COLJNTY ROAD 3 Payment(s) <br /> HOPKINS, MN CREDIT CARD 9081 51.00 <br /> (952)938-4433 <br /> OWNER <br /> HAHN,JERAD& LESLIE <br /> 809 BROWN RD N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORIv 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 l80 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 a y time for due cause. <br /> d 7 i�� i�s <br /> pplicant Permitee Signature Date Issue y Signature Date <br />