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CITY OF ORONO * Z 0 1 Z — PJ fd 6 4 5 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 07/09/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1587 MAPLE PL <br /> PIN : 08-117-23-33-0034 <br /> LEGAC,DESC : CRYSTAL BAY VIEW <br /> : LOT 012 BLOCK 006 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC PAID ON PGRMIT#2012-00436 NEW HOME,DATED 06/28/12 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WESTONKA SEWER& WATER STATE SURCHARGE SEWER& WATER 5.00 <br /> 6501 CO. RD 15 TOTAL 55.00 <br /> MOUND,MN 55364 <br /> (952)472-4959 PAID WITH CC# 7464 <br /> Minnesota State License#: 1804 <br /> OWNER <br /> Maple Place LLC <br /> 550 25TH AVE N <br /> ST. CLOUD, MN 56303- <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 /> Sta[e Building Code. This permit is for only the work described and does <br /> not gran[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 /> eommenced 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. ,/�1� <br /> The applicant is responsible for ass ring all required inspections are �`�% <br /> requested in conformance w� t �tate Building Code.This permit may be <br /> revoked ' e for c u e. � ����'��,('�� �� <br /> ��� � � �� � ( 2 ,n��--iG.��--� / <br /> � � <br /> Applicant Permitee Signature Da e Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />