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� CITY OF ORONO * z 0 1 4 - 0 1 1 6 1 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 10/08/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3309 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0016 <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B <br /> : LOT 001 BLOCK 000 <br /> PERMIT TYPE : SEWER& WA"I'ER <br /> PROPF,RTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: S1�WI��;R AND WATGR CONNF,C"1�[O'� <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> D.S.M. EXCAVATING STATE SURCHARGE SEWER& WATER 5.00 <br /> 2916 ENTERPRISE AVE TOTAL ]05.00 <br /> HASTINGS, MN 55033- <br /> (651)480-1355 Payment(s) <br /> CREDIT CARD 0444 105.00 <br /> OWNER <br /> SCHMID, DAVID <br /> 3309 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he work lor���hich this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State C3uilding Code. 'I�his pennit is for only the work describcd and does <br /> not grant permission for additional or related work���hich requires separate <br /> permits. All provisions of la��•s and ordinances governing this type of work <br /> shall be compied�vith whether or not specified herein."I�his 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 i f construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> l�he applicant is responsible for assurine all required inspections are <br /> requested in confarmancc�vi[h the State[3u�lding Code.'I'his perniit may be <br /> revoked at any time for uc cause <br /> �� � � � � �, <br /> � � D--g / � , <br /> ��� � . , �` � � �. � ,L.� �, , 4� <br /> Applicant�Permitee Signature �% Uate ' Issued C3 � ignature Datc <br />