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� s CITY OF ORONO � 1 6 - PJ PJ 4 4 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/15/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1050 EDGEWOOD HILLS RD <br /> PIN : 02-117-23-13-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1098 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> OLSONS SEWER SERVICE MAIL-IN FEE 2.00 <br /> 17638 LYONS ST NE <br /> FOREST LAKE, MN 55025- TOTAL 53.00 <br /> (651)464-2082 Payment(s) <br /> Minnesota State License#: SW-1R654644 CREDIT CARD 0380 53.00 <br /> OWNER <br /> STEINER, BARBARA <br /> 1050 EDGEWOOD HILLS RD <br /> WAYZATA, MN 55391- <br /> AGREEMEfYT 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 E3uilding 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 speci6ed herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the 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 responsibie for assuring all 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 /> � <br /> � � g,�� ,�� <br /> Applicant Permitee Signature Date Issued By gnature Date <br />