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, . � CITY OF ORONO PERMIT NO.: 2010-00294 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: OS/26/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 650 BIG ISLAND <br /> PIN : 22-117-23-31-0028 <br /> LEGAL DESC : PLEASANT VIEW LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTTON TYPE : NEW <br /> NOTE: <br /> (3)PLASTIC TANKS-ALL 1,000 GALLONS <br /> MOUND TREATMENT SYSTEM- l OX33 S.F. <br /> APPLICANT SEPT[C NEW 200.00 <br /> ABLE EXCAVATING STATE SURCHARGE SEPTIC 0.50 <br /> 15630 OLD BRICK YARD RD. <br /> SHAKOPEE, MN 55379 TOTAL 200.50 <br /> (952)445-7432 PAID WITH CC# 4966 <br /> Minnesota State License#: 077992-RP <br /> OWNER <br /> JOHNSON,JAMES A <br /> 420 4TH STREET NE#406 <br /> WATERTOWN, SD 57201-2638 <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 docs <br /> not grant permission for addi[ional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not spccified 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 /> revoke�j at any time for due ca se. <br /> �5�����(� �'� 2(P� �� � l� v <br /> Applicant Permitee Signature Date Iss d Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />