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4110k. CITY OF ORONO I 11 II I 1 11 1 F <br /> 2750 KELLEY PARKWAY * 20 1 5 - 0 1 50 6 <br /> DATE ISSUED: 11/25/2015 <br /> ORONO, MN 55356- <br /> . (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 190 ORONO ORCHARD RD S <br /> PIN : 02-117-23-21-0009 <br /> LEGAL DESC : ORONO ORCHARDS <br /> : LOT 048 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> VIEHL EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 <br /> P O BOX 295 TOTAL 51.00 <br /> PRIOR LAKE,MN 55372- <br /> Payment(s) <br /> (612)819-8367 CHECK 10783 51.00 <br /> Minnesota State License#: SW-PB644033 <br /> OWNER <br /> BRUNELLO,JOHN <br /> 7513 MAPLEWOOD DRIVE <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 /> sir CZ-5—/Z5 <br /> Ap'+i ;4 t Permttee S ure Date Issued Signature Date <br />