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CITY OF ORONO * 2 0 1 2 — 0 0 9 4 3 * <br /> , , 2750 KELLEY PARKWAY DATE ISSUED: 09/19/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1370 CHERRY PL <br /> PIN : 08-117-23-32-0022 <br /> LEGAL DESC : SAGA HILL REV[SED <br /> : LOT 000 BLOCK O11 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : RE-CONNECT <br /> NOTE: SEWER RE-CONNBCTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BURNS EXCAVATING, INC. STATE SURCHARGE SEWER&WATER 5.00 <br /> 3470 CO. RD 21 TOTAL 55.00 <br /> MAYER, MN 55360- <br /> (612)685-4303 <br /> Minnesota State License#: 1888 <br /> OWNER <br /> NAFSTAD, ERIK <br /> 1370 CHERRY PL <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and speciftcations,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 /> permi[s. All provisions of laws and ordinances governing 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 no[ <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any[ime after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the Sta[e Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ./��- _ � / �9 / �z-' i � � � � <br /> pplicant Permitee Signature Date Issue [3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />