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, , CITY OF ORONO PERMIT NO.: 2oos-oo��s <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 08/29/2008 <br /> - 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 259 HOLLANDER RD <br /> PIN : 25-118-23-43-0017 <br /> LEGAL DESC : HOLLY ACRES <br /> ,� : LOT 004 BLOCK 002 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> APPLICANT SEPTIC NEW 100.00 <br /> HAYES&SONS EXC. INC. STATE SURCHARGE SEPTIC 0.50 <br /> 263 82ND STREET S.E. TOTAL 100.50 <br /> MONTROSE,MN 55303 <br /> �) <br /> Minnesota State License#: 640 <br /> OWNER <br /> PIERCE,STEVEN&KATHERINE <br /> 259 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 pla�s and specifications,applicable Ciry 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 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 consWction 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 time for due cause. <br /> lZr l a� �i � � � <br /> Applicant Pe ee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DE RIB ABOVE. <br />