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` ' CITY OF ORONO * 2 0 1 2 — 0 0 4 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/28/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2555 FOX ST <br /> PIN : 04-117-23-44-0002 <br /> LEGAL DESC : AUDITOR'S SUBD. NO.229 <br /> : LOT O]0 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : OTHER- SEPTIC <br /> NOTE: 2 UNITS AT GRADE <br /> 3 TANKS <br /> EXISTING PUMP TANK WILL BECOME SEPTIC TANK <br /> ADDING NEW PUMP TANK <br /> APPLICANT SEPTIC NEW 200.00 <br /> GEORGE'S EXCAVATING STATE SURCHARGE SEPTIC 5.00 <br /> PO BOX 934 TOTAL 205.00 <br /> LAKEVILLE, MN 55044- <br /> (612)310-7887 PAID WITH CC# 2503 <br /> Minnesota State License#: L3368 <br /> OWNER <br /> ECKERLINE, MR.& MRS. <br /> 2555 FOX ST <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this perniit 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 specitied herein.This permit will <br /> expire and become null and void irconstruc[ion 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 afrer work has commenced. <br /> The applican[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 /> `�'L'�t��CQ �j � �� �{�L�'� i � <br /> Applicant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />