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� ' ' CITY OF ORONO <br /> * 2 0 1 4 - 0 0 9 1 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUF.D: 08/19/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3825 NORTH SHORE DR <br /> P1N : 17-117-23-22-0046 <br /> LEGAL DESC : SHERRI LAKEVIEW ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> J P SCHMITZ CONSTRUCTION COMPANY LL STATE SURCHARGE SEWER&WATER 5.00 <br /> 16450 117TH AVE N <br /> MAPLE GROVE, MN 55369- TOTAL 105.00 <br /> Payment(s) <br /> CHECK 11650 105.00 <br /> OWNER <br /> LANDSOUCE <br /> 3845 NORTH SHORE DR <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> 7�he work for which this permit is issued shall be periormcd 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 separa[e <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein."I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if eonstruction is <br /> suspended for a period of 180 days at any time alter work has commenced. <br /> "I�he applicant is responsible for assuring all requircd inspections are <br /> requested in conforman� wiU�the 'tate Building Code.This pe mi[may bc <br /> revoked a y t� r e c� e. � <br /> i�f <br /> � � ' i � � "��'�- � ✓� �/ <br /> plicant Permitee Signature ate Issued Signature Date <br />