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� � CITY OF ORONO * 2 PJ 1 3 — PJ PJ 9 6 0 * <br /> 2750 KELLEY PARKWAY pATE issu��: 12/19/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2690 CAROLINE AVE <br /> PIN : 20-117-23-24-0033 <br /> LEGAL DESC : WESSELS SUBD OF SPRING PARK LO <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: WATER& SEWER DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> KYLE HUNT& PARTNERS INC. STATE SURCHARGE SEWER&WATER 5.00 <br /> 18324 MINNETONKA BLVD <br /> DEEPHAVEN, MN 55391- TOTAL 105.00 <br /> (952)476-5999 Payment(s) <br /> Minnesota State License#: BC- 1967 CHECK 17260 105.00 <br /> OWNER <br /> LIBERMAN,ZIV &TAL <br /> 1 145 SETTLERS ROAD <br /> MEDINA, MN 55340- <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 consVuction authorired is not <br /> commenced within l80 days of thc date of issuance,or if construction is <br /> suspended Cor a period of 180 days at any time after work has commenced. <br /> "I�he applicant is responsible for assuring all required inspections are <br /> rcquested in conformance H�ith the State Quilding Code."Chis pennit may be <br /> revoked at any time for due cause. <br /> �Y�E F!:���- �' �`�-.-�-,"�,,rS,`� <br /> � I�z'���1 ��'�i� i i <br /> Applicant Permitee Signature ate Issued By gnature �l,� Date <br /> � V�,� <br /> // <br />