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CITY OF ORONO * z 0 1 4 - 0 PJ 9 2 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/20/2014 <br /> ' � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 60 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0020 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0446 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC PD ON PERMIT 2014-00918 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> KOTHRADE SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 <br /> 12059 WHITETAIL AVENUE <br /> HANOVER, MN 55341 TOTAL 105.00 <br /> �� Payment(s) <br /> Minnesota State License#: SW-192 MPCA CHECK 18821 105.00 <br /> OWNER <br /> HARTMAN,TODD <br /> 60 MYRTLEWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his 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 goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> e e and become null and void if construction authorized is not <br /> om nced within 180 days of the date of issuance,or if construction is <br /> uspen ed for a period of l SO days at any time after work has commenced. <br /> he ap lic t is responsible for assuring all required inspections aze <br /> r quest d i nforman e with the St te Building Code.This permit may be <br /> voke at i e for e cause. <br /> � / / <br /> Ap licant Permite ignature ate Issued By Si ature Date <br />