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� � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * � 0 1 5 - 0 0 0 Z 5 * <br /> DATE ISSUED: OU09/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 930 PARTENWOOD RD <br /> PIN : 08-117-23-21-0007 <br /> LEGAL DESC : PARTENWOOD <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER DISCONNECT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 0.00 <br /> KOTHRADE SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 <br /> 12059 WHITETAIL AVENUE <br /> HANOVER,MN 55341 MAIL-IN FEE 2.00 <br /> � TOTAL 57.00 <br /> Minnesota State License#: SW-192 MPCA Payment(s) <br /> CREDIT CARD 4122 57.00 <br /> OWNER <br /> MOORE,KIRK&PAM <br /> 27475 MAPLE RIDGE LANE <br /> SHOREWOOD,MN 55331- <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 goveming 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.'I'his permit may be <br /> revoked at any time for due cause. <br /> l � 9' ��S <br /> Applicant Permitee Signatur Date ssue y Signature Date <br />