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CITY OF ORONO PERMIT NO.: 2009-00762 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE [ssuEn: 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 : CONNECTION <br /> NOTE: SAC&WAYZATA SEWER CONNECTION CHARGE PAID BY I IOMEOWNER ON CASHIERS CK#731502405 <br /> PERMIT#�9A9-99�(r3- <br /> a�9 ����� <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN WATER&SEWER STATE SURCHARGE SEWER&WATER 0.50 <br /> 864 QUAIL PKWY <br /> WATERTOWN, MN 55388- WATER AVAILABILITY 50.00 <br /> TOTAL 100.50 <br /> OWNER <br /> BROWN,JESSICA <br /> 45 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 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 a[any time after work has commenced. <br /> The applican[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[ime for due cause. /�) � t <br /> • � � / ' �`1'` � `�' <br /> �jC�t� �n�l'V1�r� �� � (�`� � c�� !/`--`-/�,` � �`Y'�'�-�c-y� � � <br /> Applicant Per tee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />