Laserfiche WebLink
,.�., CITY OF ORONO * 2 0 1 6 - 0 0 7 0 7 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 06/24/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3188 NORTH SHORE DR <br /> PIN : 09-117-23-32-0011 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: 04/07/16-PER ROGER PEITSO,BUILDING OFFICIAL. SAC GRANDFATHERED IN H/U PROJECT#1785 04/10/68 AND HOME <br /> BUILT IN 1952. <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> TMS COMPANIES TOTAL 51.00 <br /> 5990 MEADOWLARK LN Payment(s) <br /> PRIOR LAKE,MN 55372- CHECK 4483 51.00 <br /> (612)414-5700 <br /> OWNER <br /> RUCINSKI,MICHEAL&HOLLY <br /> 3188 NORTH SHORE DR <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 dces <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 /> expire and become null and void if construction suthorized 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 ass g all required inspections are <br /> requested in conformance ith th te Building Code.This permit may be <br /> revoked ' e for cause. T ,�],�-, <br /> 1'lA'� <br /> �Z`7 ��..�.��G C� /Z� / �f° <br /> Ap icant Permi e Signature Date Issued By Signatur Date <br />