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CITY OF ORONO * 2 0 1 6 - 0 0 5 6 4 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 05/23/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 787 BOULDER DR <br /> PIIV : 33-118-23-11-0132 <br /> LEGAL DESC : STONEBAY <br /> : LOT 7&8 BLOCK 1 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : RE-CONNECT <br /> NOTE: THIS[S A RE-CONNECTION <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> BOLLIG& SONS, INC. TOTAL 51.00 <br /> 1 1401 COUNTY ROAD 3 <br /> HOPKINS, MN Payment(s) <br /> (952)938-4433 CREDIT CARD 6881 51.00 <br /> OWNER <br /> PIERCE FAM TRUST, MARY SUE <br /> 5491 ANDERSON ESTATES RD <br /> MAPLE PLAIN, MN 55359- <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 additional 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 specified herein.This permit will <br /> expire and become nuil 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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring aIl 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 /> � V' � �� , � <br /> ,,�_� S`������� '1�-�'�--� I��--�.��-��� �-' �� ��- �, ��, <br /> Applicant Permitee Signature Date Issued By Signature Date <br />