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' CITY OF ORONO * 2 0 1 5 — 0 0 2 3 7 * <br /> 2750 KELLEY PARKWAY pATE �ssUEn: 03/OS/2015 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 3926 CHERRY AVE <br /> PIN : 08-117-23-33-0019 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: WATER AND SEWER CONNECT[ON <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> SCHERBER COMPANY, LLC STATE SURCHARGE SEWER& WATER 5.00 <br /> 20160 75TH LANE N <br /> CORCORAN, MN 55340- TOTAL 105.00 <br /> (763)497-1100 Payment(s) <br /> CHECK 16327 105.00 <br /> OWNER <br /> WASHUTA,KENNETH <br /> 3926 CHERRY AVE <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for 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 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 permi[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 commenccd. <br /> The applicant is responsible for assuring all required inspec[ions are <br /> requested in confonnance with the State Building Code.This permit may be <br /> revok d at any time for due cause. <br /> µ...� � ' " '�� _— > �—. <br /> ' �~- ,'�. ' il C i �� l'`l��/� -� / _� � � S <br /> Applicant Permitee Signature Date [ssued By 'gnature Date <br /> I <br />