HomeMy WebLinkAboutSeptic As Built CITY OF ORONO PERMIT NO.: 2011-00498
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 06/24/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3380 GRAHAM HILL RD
PIN : 05-117-23-11-0013
LEGAL DESC : GRAHAM HILL PRESERVE 2
: LOT 000 BLOCK 000
PERMIT TYPE : SEPTIC
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : NEW
ACTIVITY : MOUND SYSTEM-SEPTIC y)
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APPLICANT SEPTIC NEW 200.00
PATNODE BROS STATE SURCHARGE SEPTIC 5.00
23200 109TH AVE
ROGERS,MN 55374 MISC FEE 0.00
(763)428-7393 TOTAL 205.00
Minnesota State License#: 95
OWNER
RUDOW, DAVID
3380 GRAHAM HILL RD
ORONO,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will co
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is C)
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be 3
revoked at any time for due cause. _
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Applicant Permitee Signature Date Issued By Siyature / .'ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER - AN DESCRIBED ABO 4.0