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� <br /> '� CITY OF ORONO PERMIT NO.: 2009-00847 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 1U25/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 30 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0011 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECT[ON <br /> NOTE: <br /> SAC AND WAYZATA SEWER CONNECTION CHARGE PAID BY HOMEOWNER ON CHECK#4731 <br /> PERMIT#2009-00846 <br /> ��,�0G�1 <br /> APPLICANT `'`'"c� e f vct�tc� �� , "� <br /> 50.00 <br /> COPPIN WATER& SEWER SEWER CONNECTION CHARGE-WAYZATA 50.00 <br /> 864 QUAIL PKWY <br /> WATERTOWN,MN 55388- STATE SURCHARGE SEWER& WATER 0.50 <br /> TOTAL 100.50 <br /> OWNER <br /> PAULSON, BRUCE& LORI <br /> 30 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 additional 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 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 cons[ruction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is cesponsible 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 /> �o; <_. Gr �-� 1 l��1� l l <br /> App�cant Permi e Signature ate Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />