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'' CITY OF ORONO <br /> � * Z PJ 1 6 — PJ 0 7 7 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/OS/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2710 KELLY AVE <br /> PIN : 21-117-23-23-0034 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: WATER REPAIR ONLY <br /> APPLICANT WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> TUMA CONSTRUCTION TOTAL 51.00 <br /> 5045 COUNTY ROAD 19 <br /> MINNETRISTA, MN 55359- Payment(s) <br /> (763)479-2982 CHECK 4721 51.00 <br /> Minnesota State License#:BUIL-PB695614 <br /> OWNER <br /> RESTORATION,ROBIN <br /> 2080 SHORELINE DR <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 specifica[ions,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 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 l80 days a[any time after work has commenced. <br /> The applicant is re onsible for assuring all required inspections are <br /> reques d�in co tate Building Code.This permit may be <br /> revo `t an ' e for d cause. <br /> � _ ��� <br /> � �—S= (� � L � � � ?� e_ "[ ;L � � S—� l � <br /> pplica Permit Signa ure Date Issued By Signature Date <br />