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' � CITY OF ORONO PERMIT NO.: 20�0-00600 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/26/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2675 FOX ST <br /> PIN : 04-117-23-43-0003 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.229 <br /> : LOT 025 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM - SEPTIC <br /> APPL[CANT SEPTIC NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 5.00 <br /> 263 82ND STREET S.E. <br /> MONTROSE, MN 55303- MISC FEE 0.00 <br /> (763)479-1762 TOTAL 205.00 <br /> Minnesota State License#: 640 PAID WITH CC# 5293 <br /> OWNER <br /> MARGARET JACKSON,CHRISTOPHER BLOOMER/ <br /> 2675 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT 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 Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified 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 conforma e wit i the State Building Code.This permit may be <br /> re oke ime fo di <br /> � � � � d � /_� <br /> pp ica �t Signature Date p <br /> Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />