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CITY O�F ORONO PERMIT NO.: 2011-00666 <br /> ' ' � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/07/20ll <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3350 FOX ST <br /> PIN : OS-117-23-44-0008 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM- SEPTIC <br /> NOTE: (3)PRECAST CONCRETE"1'ANKS- 1500, 1500 AND 1,000-PUMP'I�ANK <br /> MOUND TREATMENT SYSTEM-3,887.40 <br /> � <br /> APPLICANT SEPTIC NEW 200.00 <br /> OLSON CONSTRUCTION CO. STATE SURCHARGE SEPTIC 5.00 <br /> 6970 INWOOD ROAD TOTAL 205.00 <br /> COLOGNE, MN 55322- <br /> (952)448-6674 <br /> Minnesota State License#: L1111 <br /> OWNER <br /> BIGOS,NANCY <br /> 3350 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he 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. This permit is for only the work described and does <br /> not grant permission for addi[ional 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 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 conformance with the State Building Code.This permit may be <br /> revok t arrq time for d e ause. , <br /> �t� y, , � �, , , <br /> Applicant Permitee ignature Date <br /> � Iss By Signature Date <br /> SEPAR PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />