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CITY OF ORONO * 2 0 1 6 - PJ 0 3 2 9 * <br /> ,� 2750 KELLEY PARKWAY DATE ISSUED: 04/OS/2016 <br /> j ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3596 SHOREL[NE DR <br /> PIN : 17-117-23-43-0107 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 000 BLOCK 007 <br /> PERMIT TYPE : WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: ADDITIONAL CONNECTION FOR FIRE SUPPRESSION,OK'D BY ROGER <br /> APPLICANT WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> INDUSTRIAL UTILITIES INC TOTAL 51.00 <br /> P.O. BOX 76 <br /> HLJGO,MN 55038 Payment(s) <br /> CREDIT CARD 8481 51.00 <br /> (651)426-6120 <br /> Minnesota State License#: SW-PC643306 <br /> OWNER <br /> A Plus Properties <br /> 3596 SHORELINE DR <br /> WAYZATA, MN 55391- <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. 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 hereia 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 ti for due cause. <br /> .�, _ I�,v � I���t�c.� � <br /> G��� _� - � �� �� 1 <br /> App icant Permitee Signature Date Issued By Signature Date <br />