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w � <br /> CITY OF ORONO * 2 0 1 2 — 0 0 9 2 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/14/2012 <br /> ORONO, MN 55356— <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3443 CRYSTAL PL <br /> PIN : 17-117-23-43-0005 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECT[ON <br /> NOTE: NEW WATGR AND SGWEK CONNGCTION <br /> PIPG SIZE-4" PVC-SGWER <br /> PIPL SIZG- 1" WATER <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> SCHERBER CO. LLC WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 1 1415 VALLEY DR. <br /> ROGERS, MN 55374 STATE SURCHARGE SEWER& WATER 5.00 <br /> (763)497-1100 TOTAL 105.00 <br /> Minnesota State License#: PB644183 <br /> OWNER <br /> GULLICKSON, FRITZ <br /> 3443 CRYSTAL PL <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> llie work f'or 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[he 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 lype 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 lor as� � all required inspections are <br /> requ e � o mance with t State Building Code.This permit may be <br /> ked a ti r cau e. <br /> c � �� �l� � ��� �C(� �� � �� � Y <br /> A licant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />