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- CITY OF ORONO * Z 0 1 5 — 0 0 4 6 7 * <br /> - 2750 KELLEY PARKWAY DATE ISSUED: 04/23/2015 <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 /> PERMTT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : RE-CONNECT <br /> NOTE: SAC PAID#2998- 1974 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> KOTHRADE SEWER&WATER TOTAL 55.00 <br /> 12059 WHITETAIL AVENLTE Payment(s) <br /> HANOVER,MN 55341 CREDIT CARD 4122 55.00 <br /> 0 <br /> Minnesota State License#: SW-192 MPCA <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 Ciry approvals,and the <br /> State Building Code. 1'his permit is for only the work described and dces <br /> not grant permission for additional or related work which requires separate <br /> pertnits. 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 aIl required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. /`�Jh <br /> J� <br /> _ � � c� �� a� <br /> Applicant Permitee Signature Date Issue y Sign ture Date <br />