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' ' CITY OF ORONO PERMIT NO.: 20�0-00392 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 05/27/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2400 FOX ST <br /> PIN : 04-117-23-41-0011 <br /> LEGAL DESC : MAJESTIC SPRUCE ADDITION <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> NOTG: (3)PRECAST CONCRE'I�E TANKS-MOUND SYSTEM <br /> APPLICANT SEPTIC NEW 200.00 <br /> BURNS EXCAVATING, INC. <br /> 3470 CO. RD 21 STATE SURCHARGE SEPTIC 0.50 <br /> MAYER, MN 55360- TOTAL 200.50 <br /> �) <br /> Minnesota State License#: 1888 <br /> OWNER <br /> LINDBLOOM,JULIE <br /> 2690 RAINEY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he 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 E3uildin�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 ordinanccs governing this typc of work <br /> shall be compied with whether or no[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 /> 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> � � � �, � 7, �� <br /> Applicant Permitee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />