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CITY OF ORONO * z 0 1 5 - 0 1 5 4`u 6� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/10/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 10 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0009 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : PASS THROUGH FEES- WAYZATA <br /> NOTE: THIS IS THE SEWER&WATER CONNECT[ON&SAC FEE FOR NEW HOME PERMIT#2015-01198 <br /> PAID VIA:CK#3315$2,767.00 FOR THE SEWER&WATER PASS THROUGH FEES <br /> APPLICANT SEWER CONNECTION CHARGE-WAYZATA 602.00 <br /> WATER CONNECTION CHARGE- WAYZATA 2,165.00 <br /> Chamberlain Capital LLC TOTAL 2,767.00 <br /> 11578 CHAMBERLAIN CT Payment(s) <br /> EDEN PRAIRIE, MN 55344 CHECK 3315 2,767.00 <br /> OWNER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLA[N CT <br /> EDEN PRAIRIE, MN 55344- <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 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 with the State Building Code.This permit may be � <br /> revoked at any time for due cause. <br /> �� � <br /> ���,���, ������cs� '� � /�� f:� � �� /� �-_ — <br /> Applicant Permitee Signature Date Issued By Signa e Date <br />