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CITY OF ORONO PERMIT NO.: 2009-00262 <br /> 2750 KELLEY PARKWAY <br /> . ' ORONO, MN 55356- �ATE ISSUEn: 06/OU2009 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 325 HOLLANDER RD <br /> PIN : 25-118-23-43-0024 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1281 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> . , , <br /> �1C'_� � �,, {. �� , �, �1, � � �< i � ,i� , �� . <br /> ,�, _ <br /> APPLICANT SEPTIC NEW 200.00 <br /> PATNODE BROS <br /> 23200 109TH AVE STATE SURCHARGE SEPTIC 0.50 <br /> ROGERS,MN 55374 TOTAL 200.50 <br /> (763)428-7393 <br /> Minnesota State License#: 95 <br /> OWNER <br /> GOLINVAUX, MR. &MRS. <br /> 325 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 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 nformance wrth[he State Bu ing Code.This permit may be <br /> �D <br /> rtveRe�c �at� �time for due ' � <br /> � � � G2'� ��-� " ��� � L ��✓� X—Q�7 ��� � <br /> � � � � �� / / <br /> A icant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />