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W � CITY OF ORONO * 2 0 1 5 - 0 0 1 6 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/09/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4166 HIGHWOOD RD <br /> PIN : 07-117-23-44-0027 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 033 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER DISCONNECT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> SPECK-TACULAR COMPANIES TOTAL 55.00 <br /> 5595 270TH STREET E Payment(s) <br /> ELKO,MN 55020 CHECK 17082 55.00 <br /> n <br /> OW1vER <br /> WILLOW CREEK,DEV <br /> P O BOX 4551 <br /> ST PAUL,MN 55104- <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 dces <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 l80 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.1'his permit may be <br /> revoked at any time for due cause. <br /> / /6 <br /> ppp�i Date ssued ignature Date <br />