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L - CITY OF ORONO * Z 0 1 4 - 0 1 2 7 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/3ll2014 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3536 LYRIC AVE <br /> PIN : 17-117-23-43-0056 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER AND WATER DISCONNECT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WESTONKA SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 <br /> 6501 CO. RD IS <br /> MOLJND,MN 55364 TOTAL 105.00 <br /> (952)472-4959 Payment(s) <br /> Minnesota State License#: BUIL-1804 CHECK 10859 105.00 <br /> OWNER <br /> HENKE,CHARLES L <br /> 3536 LYRIC AVE <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEME1vT <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 rype 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 time after work has commenced. <br /> The applicant is responsible for assuring all requ' � pections are <br /> requested in conformance with the e uii ng Co .This permit may be <br /> revoke��any[ime for due ca <br /> G� . 3 <br /> - / ! /Di i / <br /> plicant Permitee Signature Date Issued Signature Date <br />