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. �. <br /> CITY OF ORONO * Z 0 1 4 - 0 0 4 9 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/2U2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : ll61 ELMWOOD AVE <br /> PIN : 07-117-23-14-0029 <br /> LEGAL DESC : SKARP& LINDQUISTS FERNHILL LA <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: S}:WER AND WAT�R CONN�CTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> D.S.M. EXCAVATING STATE SURCHARGE SEWER& WATER 5.00 <br /> 2916 ENTEfZPRISE AVE <br /> NASTINGS, MN 55033- TOTAL 105.00 <br /> (651)480-1355 Payment(s) <br /> CREDIT CARD 0444 105.00 <br /> OWNER <br /> SUNDBERG, RICHARD <br /> 5125 WEST STREEI' <br /> GREENWOOD, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is iss�ied shall be perlormed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State[�uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> perniits. 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��ays of t:ne date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformanae with the State Building Code."I�his pennit may be <br /> revoked a[any time � due caus� j <br /> % <br /> r .v ! ' ' <br /> / � / /Zi 'a `�/ '� ( / � ' j/�— ��` �� l � <br /> Applidant Permitee Signatur�: �/ Date s ed I3y Signature Date <br />