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, � " . • CITY OF ORONO PERMIT NO.: 2011-01231 <br /> • `` ' 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUEn: 10/13/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 315 HOLLANDER RD <br /> PIN : 25-118-23-43-0014 <br /> LEGAL DESC : HOLLY ACRES <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOLJND SYSTEM-SEPTIC <br /> NOTE: (2)PRECAST CONCRETE TANKS <br /> SIZE OF TANKS-(1) 1,000 GALLON <br /> -(1) 1,300 <br /> MOUND SYSTEM- 10 X 63 ROCKBED <br /> APPLICANT SEPTIC NEW 200.00 <br /> ELMER J.PETERSON COMPANY STATE SURCHARGE SEPTIC 5.00 <br /> 5921 DAGUE AVE SE TOTAL 205.00 <br /> DELANO, MN 55328 <br /> OWNER <br /> FAGRE,NATHAN&CONSTANCE <br /> 315 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 Bui(ding Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permiu. 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for'due cause. <br /> �Yv�-�"�^ lilt / / v /�""�r'L,— l l <br /> Applicant Permitee Signature Date Issued By nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />