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' � �` CITY OF ORONO * z 0 1 7 - 0 0 � 3 � * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: Q2/14/2017 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3295 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0013 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�1 TYPE : RE-CONNECT <br /> NOTE: SEWER RECONNECTION <br /> SAC GRANDFATHERED IN H/U#1936 08/30/68 AND#3281 08/31/72 <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> SCHERBER COMPANY,LLC STATE SURCHARGE SEWER&WATER 1.00 <br /> 20160 75TH LANE N <br /> CORCORAN, MN 55340- TOTAL 101.00 <br /> (763)497-1100 Payment(s) <br /> CHECK 17827 101.00 <br /> OWNER <br /> GREG BLASKO&WHITNEY WINDMILLER <br /> 3295 CRYSTAL BAY 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 reqaires separate <br /> permits. All provisions of laws and ordinances governing 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. �� � <br /> lCr:. <br /> �-� �� ,) � � <br /> � � ' <br /> �.�.`- <br /> 1_;�.-i� ; ��c��-r_ �� /-_ � �__�;�� .:� , %y, / -? <br /> Applicant P mitee ignature Date Issued By Signature Date <br />