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CITY OF ORONO * 2 0 1 5 - r� 0 7 1 7 * <br /> ` ' 2750 KELLEY PARKWAY DATE ISSUED: 06/18/2015 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 333 HOLLANDER RD <br /> PIN : 25-118-23-43-0005 <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 OR REPLACEMENT(SEPTIC SYSTEM) � <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> i" <br /> NOTE: NEW MOUND SEPTIC SYSTEM � � <br /> (3)PRECAST CONCRET TANKS- 1250, 12Q 1600 <br /> MOUND-4608 S.F. <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> PATNODE&SONS .����� TOTAL 405.00 <br /> 23200 109TH AV �" � ,� '� Payment(s) <br /> ROGERS,M�74� � � CREDIT CARD 5822 405.00 <br /> (763)428�3 <br /> Minn�6'ia State License#: sept-95 � <br /> OWNER <br /> TANNER,JOHN& DONNETTE <br /> 333 HOLLANDER RD � <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SV�bRN STATEMENT <br /> The work for which this permit is iss ed shall be performed according to <br /> the approved plans and specificati s,applicable City approvals,and the <br /> State Building Code. This permit is�ef 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 wmmenced. <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 /> � - � �� �ZG� <br /> � (� �� 1 �� i ��� �i � �i �S <br /> Applicant Permitee Signature Date [ssue By Sig ure Date <br />