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, . . CITY OF ORONO PERMIT NO.: 2010-00713 <br /> 2750 KELLEY PARKWAY <br /> + ' ORONO, MN 55356- DATE ISSUED: 08/16/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2630 FOX ST <br /> P�N : 04-117-23-42-0009 <br /> LEGAL DESC : REG. LAND SURVEY NO. ]249 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM - SEPTIC <br /> NO'1'E: DRAINAGE [SSUES-CULVF,RT HEIGHT-DISCUSS ONS[TE <br /> (3)PKECAST CONCRETE 1300 GALLON TANKS-MOUND SYS�I'EM 630 S.F. <br /> APPLICANT <br /> SEPT[C NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 5.00 <br /> 263 82ND STREET S.E. <br /> MONTROSE, MN 5530.i- TOTAL 205.00 <br /> (763)479-1762 PAID W[TH CC# 5293 <br /> Minnesota State License#: 640 <br /> OWNER <br /> WEHRMANN, KEVIN <br /> 2630 FOX ST <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for��hich this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 'Chis pcnnit is for only the work described and does <br /> not grant permission for additional or relatcd work which requires separate <br /> pennits. All provisions of laws and ordinances governing this rype of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void it'construction authorized is not <br /> commenced�vithin I 80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any timc after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> rcquested in conlormance with the Statc E3uildin�Code.This permit may be <br /> revoked at a ime for d cause. <br /> ,.� - _ /v <br /> � - , 1� , � � �; � ; <br /> Applicant ermitee. ' nature Date Iss E3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />