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CITY OF ORONO rERMiT No.: 2010-01172 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/16/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1190 LYMAN AVE <br /> PIN : 35-118-23-43-0034 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1067 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: INSTALLING(3)PRECAST CONCRETE TANKS-(1)TANK- 1500 GALLONS,(2)TANKS- 1,000 GALLONS EACH <br /> MOUND SEPTIC SYSTEM-500 S.F. <br /> � ALLEY EXC.PAID FOR THIS PERMIT 12/30/10 WITH A CHECK THAT WAS SENT AND MISAPPLIED TO THE HOMEOWNER'S UTILITY <br /> BILL INSTEAD OF TO THE PERMIT. ACCOUNTING IS ADJUSTING THE ACCOUNTS AND PERMIT WILL BE ISSUED. BGS/PZJSP <br /> � <br /> APPLICANT SEPTIC NEW 200.00 <br /> ALLEY EXCAVATING STATE SURCHARGE SEPTIC 5.00 <br /> 5508 LATHROP AVE NW TOTAL 205.00 <br /> ANNADALE,MN 55320 <br /> (320)2742528 <br /> Minnesota State License#: 92 <br /> OWNER <br /> PALMER,BRIAN&NLIA <br /> 1190 LYMAN AVE <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 sepazate <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 I 80 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 with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / � <br /> Applicant Permitee Signature Date Issued B 'gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />