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, CITY OF ORONO * z 0 1 z - 0 1 z 6 z * <br /> � 2750 KELLEY PARKWAY DATE �SSUED: 12/20/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 325 CRESTVIEW AVE <br /> P1N : OS-117-23-14-0031 <br /> LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK <br /> : LOT 000 BLOCK 005 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : RE-CONNECT <br /> NO"I�F.: THIS IS A RECONNGC�I�nNI,Y. <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN WATER &SEWER STATE SURCHARGE SEWER& WATER 5.00 <br /> 864 QUAIL PKWY <br /> WATERTOWN, MN 55388- TOTAL 55.00 <br /> OWNER <br /> SULLIVAN, WENDY <br /> P.O. BOX 581774 <br /> MINNEAPOLIS, MN 55401- <br /> AGREEMENT AND SWORN STATEMENT <br /> fhe�cork for which this permit is issued shall be performed according to <br /> thc approved plans and specifications,applicable Ciry approvals,and thc <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 separatc <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.'Chis pennit will <br /> espire and become null and void if construction authorized is not <br /> commenced�vithin 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 /> Thc applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State E3uilding Code.'I�his permit may be <br /> revoked at any time for due cause. ' �� J�,F'-' <br /> � �LGwv�-/�_ �oZ � -Z� � \ C�^ 1 ° ,L 'L � ,_'i�,�< < �, / j:-� —�_�� �� <br /> �... <br /> Applicant 1 en itee Signature Datc lssued f3��Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />