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- � CITY OF ORONO * z 0 1 z - 0 0 8 0 z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/28/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 420 DEBORAH DR <br /> PIN : 31-118-23-23-0009 <br /> LECAL DESC : MCCULLEY FARM <br /> : LOT 006 BLOCK 002 <br /> PERMIT TYPE : SEPT[C <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> NOTE: (3)PRECAST CONCRETE TANKS-(1) 1500 AND(2) 1300 <br /> MOUND TREA'I'MENT SYSTFM-500 S.F. <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 5.00 <br /> 263 82ND STREET S.E. TOTAL 205.00 <br /> MONTROSE, MN 55303- <br /> (763)479-1762 PAID WITH CC# 5293 <br /> Minnesota State License#: L640 <br /> OWNER <br /> BRADY, ROBERT& RACHAELLE <br /> 420 DEBORAH DR <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> I'he work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable Ciry approvals,and the <br /> State Building Code. "I�his permit is for only the work described and does <br /> not grant permission for additional or related work which requires separatc <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not speeified 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 timc atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance��ith the Slate Building Code.This permit may be <br /> d any tin f due cause. <br /> . � � �'� 2�/Z <br /> pplican r tee Signature Date Issued �Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />