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CITY OF ORONO * 2 0 1 3 - 0 0 9 6 S <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS 3590 NORTHERN AVE <br /> PIN 17-117-23-43-0138 <br /> LEGAL DESC WILEYS PARK LAKE MTKA <br /> LOT 008 BLOCK 002 <br /> PERMIT TYPE SEWER&WATER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE CONNECTION <br /> NOTE: SEWER AND WATER CONNECTION <br /> SEWER PIPE SIZE-4 INCH-SCHEDULE 40 AIR TESTED <br /> WATER PIPE SIZE-2 INCH-POLY <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WESTONKA SEWER&WATER WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 6501 CO.RD 15 <br /> MOUND, MN 55364 STATE SURCHARGE SEWER&WATER 5.00 <br /> (952)472-4959 MAIL-IN FEE 2.00 <br /> Minnesota State License#: 1804 TOTAL 107.00 <br /> PAID WITH CC# 7464 <br /> OWNER <br /> MAENNER,BRADLEY&AMANDA <br /> 2130 TAMARACK <br /> LONG LAKE,MN 55356- <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 separate <br /> permits. All provisions of laws and ordinances governing 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 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 required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked any time for due cause. <br /> 1-7 <br /> Applicant Permitee Signature Date ssue By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />