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CITY OF ORONO PERMIT NO.: 2009-00882 <br /> 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE IssuEn: 12/07/2009 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2105 SUGARWOOD DR <br /> PIN : 34-118-23-21-0017 <br /> LEGAL DESC : SUGAR WOODS <br /> : LOT 003 BLOCK 003 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC WILL BE COLLECTED ON NEW HOME PERMIT#2009-0073Q WHICH I-IAS NOT BEEN PICKED UP YET,BUT HAS BEEN <br /> APPLIED FOR <br /> APPLICANT SEWER CONNECT/D[SCONNECT/REPAIR 50.00 <br /> MEINY'S DIGGERS, INC. WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 12231 43RD ST NE <br /> ST. MICHEAL, MN 55376- STATE SURCHARGE SEWER& WATER 0.50 <br /> (763)497-2236 TOTAL ]00.50 <br /> OWNER <br /> SMITH, THOMAS&VIRGINIA <br /> 2105 SUGARWOOD DR <br /> LONG LAKE, MN 55356 <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 governing this type of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of[he 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 are <br /> requested in conformance wi[h the State Building Code.'I'his permit may be <br /> revoked at any time for due cause. <br /> a <br /> ; r r 6�i � � _ .,. _� �. <br /> � G�(.t, �'� � �. � �b ,."/ �L�'� ,� �.�.. �_ ( �`)"7 i�'; r�� � <br /> / / <br /> Ap I�cant Permitee Signature Date Issued By Signature Date <br /> 1 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />