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� ' CITY OF ORONO <br /> * Z 0 1 5 - 0 0 0 7 0 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: OU22/2015 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1141 ELMWOOD AVE <br /> PIN : 07-117-23-14-0027 <br /> LEGAL DESC : SKARP& LINDQUISTS FERNHILL LA <br /> : LOT 007 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTIOI'�1 <br /> NOTE: NEW SEWER CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> DERUDDER EXCAVATING TOTAL 55.00 <br /> 4910 HICKORY HILLS TRAIL <br /> PRIOR LAKE,MN 55372- Payment(s) <br /> CREDIT CARD 1206 55.00 <br /> (952)447-8921 <br /> Minnesota State License#: plbg-073940 <br /> OWNER <br /> ALNESS, RYAN& STACY <br /> 1141 ELMWOOD 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 /> no[grant permission for additional or related work which requires separa[e <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or no[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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring alI required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> � � ��/S <br /> Applicant Permitee Signature Date Issued y Signature Date <br /> I <br />