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' � CITY OF ORONO * Z 0 1 6 - 0 1 3 4 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/2ll2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3060 FOX ST <br /> PIN : 04-117-23-32-0002 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> : LOT 032 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION AND E1 GRINDER 1NSTALL <br /> SAC PAID ON SAC ONLY PERMIT#2016-01397 10/21/16 <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&�VATER 1.00 <br /> KOTHRADE SEWER&WATER TOTAL 51.00 <br /> 12059 WHITETAIL AVENUE Payment(s) <br /> HANOVER, MN 55341 CREDIT CARD 9381 51.00 <br /> 0 <br /> Minnesota State License#: plbg-RP645681 <br /> OWNER <br /> PARKINSON,TIMOTHY& KRISTI <br /> 3060 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This pertnit is for only the work described and docs <br /> not grant permission for additional or related��ork which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whed�er 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 arc <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � <br /> -� � �l� � i/� <br /> Applicant ermite ignature Date lssued B i�ature Date <br />