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' ' ' CITY OF ORONO * z 0 1 5 - 0 1 4 1 5 * <br /> �' 2750 KELLEY PARKWAY DATE 1SSUED: 1 UO3/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1151 NORTH ARM DR <br /> PIN : 07-117-23-14-0052 <br /> LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION /� - <br /> _ � �-�SP �Cz.c,C�� <br /> NOTE: SEWER CONNECTION-4"PIPE SCHEDULE 40 ��� ���-�'�`1(Y� / �(Qr l't �TL'�'" <br /> �i VllL. . <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> WESTONKA SEWER&WATER TOTAL 51.00 <br /> 6501 CO. RD 15 <br /> MO[JND,MN 55364 Payment(s) <br /> CHECK 2055 51.00 <br /> (952)472-4959 <br /> Minnesota State License#: BUIL-1804 <br /> OWNER <br /> VOGSTROM, PAUL <br /> 1151 NORTH ARM DR <br /> MOiJND,MN 55364- <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 goveming 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 construc[ion is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conforman tate Building Code.This permit may be <br /> revoked at any[i or due c . . <br /> d- �-� G � 1 � -��� <br /> Applicant Permitee Signature Date Issued B Signature Date <br /> / <br />