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, CITY OF ORONO PERMIT NO.: 2011-01084 <br /> • � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/27/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2965 DEER RUN TR <br /> PIN : 04-117-23-24-0012 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 005 BLOCK 004 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM -SEPTIC <br /> APPLICANT <br /> SEPT[C NEW 200.00 <br /> ELMER J. PETERSON COMPANY STATE SURCHARGE SEPTIC 5.00 <br /> 5921 DAGUE AVE SE TOTAL 205.00 <br /> DELANO, MN 55328 <br /> OWNER <br /> SWENSON,MICHAEL&CAROL <br /> 2965 DEER RUN TR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall bc perYormed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions ot�laws and ordinances governing[his type ofwork <br /> shall be compied wi[h�vhether 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 date of issuance,or if construction is <br /> suspcnded for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State f3uilding Code.This permit may be <br /> rev � d a y time for due cause. <br /> l2� ld ���1/ <br /> App icant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />