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� � CITY OF ORONO <br /> * Z 0 1 5 - 0 0 6 5 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/2U2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1270 FRENCH CREEK DR <br /> pIN : 10-117-23-32-0014 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 006 BLOCK 002 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> t�c T� v I T`1 . r'�`i Fi C R-s�'Z-�f�c <br /> NOTE: NEW CHAMBER SYSTEM- 1 l03 S.F. <br /> (1)PRECAST CONCRETE TANK- 1250 GALLON <br /> �TyPt' C'HF�r�B�R T3�� <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> SWEDLLIND SEPTIC TOTAL 405.00 <br /> 930 DEER CREEK PARKWAY Payment(s) <br /> MN 560ll- CHECK 1875 405.00 <br /> 952-657-1034 <br /> OWNER <br /> MUELLER,ANDREA <br /> 1270 FRENCH CREEK DR <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[he work described and does <br /> not grant permission for additional or related work which requires separate <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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. a <br /> �.� �� / . _ <br /> �� �� � <br /> � �� , � �-1 ��S <br /> Applicant Permitee Signature ate�' Issued Signature Date <br /> v <br />