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� <br /> � CITY OF ORONO * 2 0 1 7 — 0 1 2 6 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/05/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2100 SHADYWOOD RD <br /> PIN : 17-117-23-31-0041 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 030 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: SEWER REPAIR <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> TRIPLE E WATER AND SEWER STATE SURCHARGE SEWER&WATER 1.00 <br /> 5016 MITCHELL ROAD TOTAL 51.00 <br /> BIG LAKE,MN 55309- Payment(s) <br /> CREDIT CARD 4864 51.00 <br /> OWNER <br /> TAMTE,MICHEAL&MEGAN <br /> 2100 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORI�t STATEMENT <br /> The work for which this permit is issued shall be performed acwrding to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his 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 governin�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 suthorized 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 /> � �� ��-s- ,-� /� �5 /,7 <br /> icant Pe._ Date Issued Signature Date <br />