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111111111111 111111111111111111111 <br /> CITY OF ORONO * 2 0 1 5 — 0 0 6 6 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/27/2015 <br /> ORONO,MN 55356- <br /> 952 2494600 FAX: 952 249-4616 <br /> ADDRESS : 3740 NORTHERN AVE <br /> PIN : 17-117-23-34-0088 <br /> LEGAL DESC : REG.LAND SURVEY NO.0763 <br /> LOT 2 BLOCK 1 <br /> PERMIT TYPE SEWER&WATER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE CONNECTION <br /> NOTE: SEWER AND WATER 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 2854 105.00 <br /> OWNER <br /> Atlas Homes <br /> 7082 EAST FISH LAKE RD <br /> MAPLE GROVE,MN 55311- <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 at any time for due cause. <br /> Applicant Permitee Signaftife Date Issue y Signature Date <br />