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.. CITY OF ORONO * Z 0 1 5 - 0 0 5 2 6 * <br /> { 2750 KELLEY PARKWAY DATE ISSUED: OS/04/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1275 LYMAN AVE <br /> PIN : 02-117-23-21-0027 <br /> LEGAL DESC : ORONO ORCHARDS HIGHLANDS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> WESTONKA SEWER& WATER <br /> 6501 CO. RD 15 S.A.C. 2,485.00 <br /> MOLTND, MN 55364 TOTAL 2,540.00 <br /> (952)472-4959 Payment(s) <br /> Minnesota State License#: BUIL-1804 CHECK 6658 &7: 2,540.00 <br /> OWNER <br /> MCMILLAN,HOWARD&ELIZABETH <br /> 1275 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[he 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 rype 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with f�ie S Building Code.This permit may be <br /> revoked at�time for due ausC. <br /> �� i� �',- <br /> _ _ i <br /> /,=� S <br /> " % =r ' ` r� — ( � '--�. ._r_�. . ��y���✓1 _5� �I � � s� ._ <br /> . �,.% � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />