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CITY OF ORONO * 2 0 1 6 - 0 1 3 2 � <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/3U2016 <br /> � ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 215 HOLLANDER RD <br /> PIIv : 25-118-23-44-0013 <br /> LEGAL DESC : HOLLY ACRES 2ND ADDN <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> NOTE: (3)PRECAST CONCRETE TANKS-EACH 1500 GALLONS <br /> MOUND SYSTEM-119.6 X 64.3=7,690 <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> HAYES&SONS EXC.INC. Payment(s) <br /> 263 82ND STREET S.E. CREDIT CARD 6685 400.00 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#:sept-L640 <br /> OWNER <br /> CLAPP,THOMAS&LAURA <br /> 215 HOLLANDER RD <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 the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified hereia This pertnit 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 'me fo due cause. � <br /> ___.__.. �.. <br /> �of ,_� C_--I��c1 � / �-e.�`f� � � , 3 r ,�� <br /> � � <br /> Appl�cant Perm Signature Date Issued By Signature Date <br />