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„ CITY OF ORONO * 2 0 1 2 — 0 1 z 0 7 * <br /> * 2750 KELLEY PARKWAY DATE ISSUED: 1U29/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3215 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0010 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: SI;WI�;K REP�11K ONLY <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BENJAMIN FRANKLIN PLUMBING STATE SURCHARGE SEWER& WATER 5.00 <br /> 1424 3RD STREET N <br /> MINNEAPOL[S, MN 5541 1- TOTAL 55.00 <br /> (763)755-6468 PAID WITH CC# 8985 <br /> OWNER �� <br /> PRUETER, MARK <br /> 3215 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORIV STATEMEIVT <br /> The work for which this permit is issued shall be performed accordin�to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Code. This pennit 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 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 construction is <br /> suspended for a period of 180 days at any time atter 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. ;� j � <br /> ����r;;�ji�,�%�--_ �I / a�l/ �'�- i c, � �` � 7 ' 1 � , �' <br /> , r � � _ <br /> pp �ermite . ignature Date [ssued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />