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, CITY OF ORONO PERMIT NO.: 2009-00770 <br /> ` 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssUEn: 10/29/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 45 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0015 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE . ��.(�`_> �����j���,4[`�-� � <br /> City af Orarra <br /> 2750 Kelley Parkway <br /> NOTE: THIS IS SAC&WAYZATA SEWER CONNECTION FEE FOR PERMIT#2( �� � 5� �-�4�� <br /> PA[D WITH CASHIERS CHECK#731502405 ReCeipt I�: 3.�16�6 ikt 29, P�9 <br /> lessica 9rown <br /> Per�its <br /> 2009-Od77d - 45 Myrtlewo 5c5.0(? <br /> ad Rd <br /> 141-20807 <br /> Nayzata Wtr/5w�^ Conr�ection Fee <br /> Ger�its <br /> 2U09-00770 - 45 Myrtlewoo 2,U06.OQ <br /> d Rd <br /> 1G1-248G9 <br /> SAC Charges due to M�C <br /> Tatal: �,�•� <br /> Check <br /> Check No: 73150�4U5 2,525•UO <br /> Payor: <br /> Jessica Bram <br /> Total Rpplied: �,�•� <br /> APPLICANT SEWER CONNECTION CHARGE-WAYZATA 525.00 <br /> BROWN, JESSICA <br /> 45 MYRTLEWOOD RD S.A.C. 2,000.00 <br /> WAYZATA, MN 55391- TOTAL 2,525.00 <br /> (952)476-2575 <br /> OWNER <br /> BROWN,JESSICA <br /> 45 MYRTLEWOOD RD <br /> WAYZATA, MN 55391- <br /> AGREEMEIVT 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[ime after work has commenced. <br /> The applicant is responsible for assuring all requiced 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 /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />