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� `� CITY OF ORONO * z 0 1 5 - 0 1 5 0 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U30/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 100 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0016 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIO[�I TYPE : CONNECTION <br /> NOTE: WATER&SEWER CONNECTON <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> GROTH SEWER&WATER WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 775 TOWER DRIVE STATE SURCHARGE SEWER& WATER 1.00 <br /> HAMEL, MN 55340- TOTAL 101.00 <br /> (763)478-6712 Payment(s) <br /> CHECK 10560 101.00 <br /> OWNER <br /> PETERS, BARRY& KRIS <br /> 19210 HACKAMORE ROAD <br /> CORCORAN, 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 /> 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 not <br /> commenced within 180 days of the date of issuance,or if cons[ruction 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 th tate Building Code.This permit may be <br /> revok t any time for due c � <br /> . ,�� � -e /� i � il5 <br /> A li n rmit Signature Date [ssued By gnature Date <br />