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CITY OF ORONO * z 0 1 5 - 0 0 7 2 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2015 <br /> , ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2490 CARMAN ST <br /> pi� : 20-117-23-12-0065 <br /> LEGAL DESC : LEHMAN LAGOON <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC PAID#2014-01488 05/27/15 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> D.S.M. EXCAVATING TOTAL 100.00 <br /> 2916 ENTERPRISE AVE Payment(s) <br /> HASTINGS,MN 55033- CREDIT CARD 0444 100.00 <br /> (651)480-1355 <br /> OWNER <br /> Lakeshore Holdings LLC <br /> 153 E LAKE ST <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 dces <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 /> revoked at any time for due cause. <br /> -� /Z G 7 <br /> " ° ��g--1� � = r C';� � r r i � i /S <br /> Applicant ermitee Signature Date Issued y Signatur Date <br />