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, CITY OF ORONO * Z pJ 1 7 - 0 0 4 5 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/OS/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 290 CRESTVIEW AVE <br /> PIN : OS-117-23-14-0018 <br /> LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: REPA[R/MOVING LINES-NO NEED FOR SAC <br /> OK'D BY ROGER <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> D.S.M. EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 <br /> 2916 ENTERPRISE AVE <br /> HASTINGS, MN 55033- TOTAL 101.00 <br /> (651)480-1355 Payment(s) <br /> CREDIT CARD 0444 101.00 <br /> OWNER <br /> HOCHSTEDLER, SCOTT <br /> 290 CRESTVIEW AVE <br /> LONG LAKE, MN 55356- <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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time afrer 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 /> � �...1 jZ_. ^�?��i ���`L'^• C- <br /> /y'k-�- �;�'/� ��c�� l�� -� � � � i � <br /> Applicant Pe�itee Signature � Date Issued By Signature Date <br />