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, CITY OF ORONO * Z 0 1 7 - 0 0 5 0 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 05/25/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2510 CASCO POINT RD <br /> PIN : 20-117-23-21-0016 <br /> LEGAL DESC : TOWNS[TE OF LANGDON PARK <br /> : LOT 004 BLOCK 006 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: DISCONNECT ONLY <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STONEWOOD, LLC WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> 153 E LAKE STREET STATE SURCHARGE SEWER&WATER 1.00 <br /> WAYZATA, MN 55391- TOTAL 101.00 <br /> (612)462-4000 Payment(s) <br /> Minnesota State License#: BUIL-BC594315 CHECK 14767 IOL00 <br /> OWNER <br /> HART,MICHAEL&KRISTIN <br /> 2510 CASCO PT 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 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ;�_ - � ^ <br /> ' / _ <br /> . ,� � � �v��..�.,�, E'�._���-�� �� �i !� <br /> � -�� _� � ��-� ._ <br /> Applicant Permitee Signature Date Issued By Signature Date <br />