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• <br /> CITY OF ORONO 1 1 11 1 111 I� �1_1 I 1 I 1 1 1� 11 1 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/27/2018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1525 LONG LAKE BLVD <br /> PIN : 35-118-23-22-0002 <br /> LEGAL DESC : ALBEES LONG LAKE ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION <br /> 4"PIPE <br /> SCH 40 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> KOTHRADE SEWER&WATER TOTAL 51.00 <br /> 12059 WHITETAIL AVENUE <br /> Payment(s) <br /> HANOVER,MN 55341 CREDIT CARD 4122 51.00 <br /> Minnesota State License#:plbg-RP645681 <br /> OWNER <br /> TAMOSUINAS,LINDA <br /> 430 PHEASANT RIDGE ROAD <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 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 Signature Date Issued ignature Date <br />