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> - <br /> ' CITY OF ORONO * z 0 1 Z - 0 0 6 B 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/17/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3980 DAHL RD <br /> PIN : 08-117-23-23-0001 <br /> LEGAL DESC : UNPLATTED 08 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: <br /> SEWR DISCONNEC"1'-4" PIPE -SCHEDULF,40 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> J S STEWART COMPANIES, INC. STATE SURCHARGE SEWER& WATER 5.00 <br /> 1]099 LAMONT AVE NE TOTAL 55.00 <br /> HANOVER, MN 55341 <br /> O PAID WITH CC# 8391 <br /> OWNER <br /> MCGLYNN, THOMAS&TON[ <br /> 3980 DAHL RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perYormed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> Sta[e 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�i�i[h whe[her or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the�ete of issuance,or if construction is <br /> suspended for a period of I 80 y at any time after work has commenced. <br /> T pplic t is respo t le y�ssuring all required inspections are <br /> quested i confor nce e Building Code.This permit may be <br /> revokcd any ' or � ause. <br /> _ � l-G ? l I � � � / <br /> pplicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />