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" CITY OF ORONO PERMIT NO.: 2010-00529 <br /> 2750 KELLEY PARKWAY <br /> "' ORONO, MN 55356- DATE ISSUEn: 06/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 25 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0014 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE . SEWER&WATER ._;,�� !;r;;t:y �tr�Ha.} <br /> PROPERTY TYPE : RESIDENTIAL `_r•ona � �� 9�'-"�t��t',`� <br /> CONSTRUCTION TYPE : PASS THROUGH FEES F�_e$�t��`' <br /> ?Ya F: <br /> NOTE: THIS IS THE SEWER&WATER CONNECTION&SAC FEE FOR Pl <br /> iL5 <br /> PAID VIA:CHECK 7326 "�i,,_�� � ��,#1�� ��c:r: ,. <br /> kd <br /> '�!1-c^.G9f�7 <br /> ��,yzat3 �ltr-.d5as• C.�nnect�ca;� �:-, <br /> '�ra:t� <br /> ,;��1-{�f1J� ty� �1+1".IFMh.`�p� .� %1::,,, ,. <br /> .� ��<<. <br /> ;(.}x—cfi$O i <br /> r;'���3od �Pi�" �LRYr�CtlOfl �� <br /> eJ^I�1L5 <br /> ;i3(1--�}t)`.i�''9 ?'5 Ikyi'1��e-'��`•' ' `s <br /> ':J <br /> )�-2�i849 <br /> :,:�: t�arge�:; �iue tu r< <br /> i'atml: ;�:.,, .. <br /> �;���.�_ <br /> ����;��� <br /> �;r,�:lc N�: <br /> t���r•: <br /> :,: �+.; <br /> APPLICANT SEWER CONNECTION CHARGE- WAYZATA 555.00 <br /> RYAN, STEVEN&ANNE WATER CONNECTION CHARGE- WAYZATA 2,020.00 <br /> 25 MYRTLEWOOD RD <br /> WAYZATA,MN 55391- S.A.C. 2,100.00 <br /> TOTAL 4,675.00 <br /> OWNER <br /> RYAN, STEVEN&ANNE <br /> 25 MYRTLEWOOD 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 addi[ional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified hercin.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced wi[hin 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 aze <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 By � ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />