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. CITY OF ORONO PERMIT NO.: 2009-00920 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE Iss[1En: 12/30/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3105 CASCO PO[NT RD <br /> PIN : 20-117-23-34-0006 <br /> LEGAL DESC : REG. LAND SURVEY NO. 131 1 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> APPLICANT WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> DASEN CO. STATE SURCHARGE SEWER& WATER 0.50 <br /> 24245 NATCHEZ <br /> LAKEVILLE,MN 55044- TOTAL 50.50 <br /> (952)461-2100 PAID WITH CC# ,��kf� <br /> Minnesota State License#: 1612 <br /> OWNER <br /> RICHEY, KENT& SUE <br /> 3105 CASCO PT RD <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 Quilding Code. This permit is Yor 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 specitied herein.This permit will <br /> expire and become null and void if construc[ion 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 timc after work has commenced. <br /> "Che 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 /> """' � � / / <br /> Applicant Perm tee Signature Date Issued By ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV <br />