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� - <br /> CITY OF ORONO PERMIT NO.: 2011-00246 <br /> ,/ . " 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE isSUE�: 04/27/2011 <br /> r (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3300 FOX ST <br /> PIN : OS-117-23-44-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1358 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> �, CONSTRUCTION TYPE : NEW <br /> I <br /> I !�1��+� <br /> � <br /> � <br /> � <br /> � <br /> APPLICANT SEPTIC NEW 200.00 <br /> PATNODE BROS STATE SURCHARGE SEPTIC 5.00 <br /> 23200 109TH AVE <br /> ROGERS, MN 5�374 MISC FEE 0.00 <br /> (763)428-7393 TOTAL 205.00 <br /> Minnesota State License#: 9� <br /> OWNER <br /> TRUBECK, WILLIAM &JUDITH <br /> 3300 FOX ST <br /> LONG LAKE, MN 55356- <br /> I <br /> AGREEMENT AND SWORN STATEMENT <br /> � 'I�hc�vork for which diis permit is issucd shall bc perti�rmcd according to <br /> the approved plans and spccilications,applicable City approvals,and the <br /> ( Stalc 13uilding Code. This pcnnit is for only thc work dcscribcd and docs <br /> � not grant permission for additional or related work which requires separatc <br /> permits. All provisions of la�vs and ordinances�,overning this type of work <br /> shall be compicd with whether or not specified herein."I'his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance wRFr�fJ�t St te Buildii�g Code.This permit may bc <br /> revok e Y'or du caus . <br /> '�S��� G�� �\ l <br /> Applicant Permitee Sig ature Date � � <br /> Issued B ignature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />