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CITY OF ORONO * 2 0 1 5 - 0 0 B z 7 * <br /> � . ., 2750 KELLEY PARKWAY DATE ISSUED: 06/29/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3382 SHORELINE DR <br /> PIN : 17-117-23-44-0100 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 005 BLOCK 003 <br /> PERMIT TYPE : WATER <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: WATERLINE FOR A SPRINKLER SYSTEM <br /> APPLICANT WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> WIDMER CONSTRUCTION LLC TOTAL 55.00 <br /> 9455 COUNTY RD. 15 Payment(s) <br /> MAPLE PLAIN,MN 55359 CHECK 1952 55.00 <br /> (952)955-5062 <br /> OWNER <br /> Narrows LLC <br /> PO BOX 36 <br /> NAVARRE,MN 55392- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfortned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pertnit is for only the work described and dces <br /> not grant pertnission for additional or related work which requires sepazate <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 consuuction 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 /> ' - _ ,-- O �-e(�S�t� �P � 2 9� ! <br /> �1/� � �as �.� <br /> Applicant Permitee Signature Date Issued By S' ture Date <br />