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' '�`' CITY OF ORONO PERMIT NO.: 2009-00294 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/09/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3447 CRYSTAL BAY RD <br /> PIN : 17-117-23-43-0122 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTiON TYPE : DISCONNECTION <br /> NOTE: <br /> WATER AND SEWER DISCONNEC"i' <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN PLUMBING WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 8460 COUNTY RD 15 <br /> M[NNETRISTA, MN STATE SURCHARGE SEWER& WATER 0.50 <br /> �6iz�24o-6z2o TOTaL ioo.so <br /> Minnesota State License#: 58745 <br /> OWIVER <br /> NO KNOWN OWNER <br /> AGREEMENT AND SWORN STATEMENT <br /> The�vork for which this permit is issued shall be performed according to <br /> thc approved plans and specitications,applicable City approvals,and the <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 l80 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 /> reque in confonnance � h the State Building Code.This permit may be <br /> rev ed t any time for ue cause. <br /> � � ' / /U� / / <br /> Appl ca t Permitee ig Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />