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� CITY OF ORONO * 2 PJ 1 6 - 0 0 3 5 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/11/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1220 BRACKETTS POINT RD <br /> pIN : 11-117-23-32-0018 <br /> LEGAL DESC : RGT ORONO POINT <br /> : LOT 000 BLOCK 000 <br /> PERM[T TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER DISCONNECT <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> COPPIN SEWER&WATER TOTAL 51.00 <br /> 864 QUAIL PKWY Payment(s) <br /> WATERTOWN,MN 55388- CHECK 4843 51.00 <br /> (612)508-9974 <br /> Minnesota State License#: SW-57329MR <br /> OWNER <br /> HANNAFORD,JULE&ELIZABETH <br /> 1220 BRACKETTS 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 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 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 /> ---- <br /> -- -------_. <br /> " ' `f`��.- � "1 l%;. -�-,e � �'z '�j < � i �-t, <br /> ,,.. <br /> Applicant Permite ignature Date Issued B gnature Date <br />