HomeMy WebLinkAboutSeptic As BuiltCITY OF ORONO
2750 KELLEY PARKWAY
ORONO, MN 55356-
1249-4600 FAX: (952) 249-4616
ADDRESS
1020 WILLOW DR N
PIN
27-118-23-32-0022
LEGAL DESC
SHADOWOOD FARM
LOT 000 BLOCK 000
PERMIT TYPE
SEPTIC
PROPERTY TYPE
RESIDENTIAL
CONSTRUCTION TYPE
NEW
PERMIT NO.: 2008-00069
DATE ISSUED: 07/23/2008
APPLICANT
PATNODE BROS
23200 109TH AVE
ROGERS, MN 55374
(763) 428-7393
Minnesota State License #: 95
OWNER
COX, JAMES & BERADINE
1020 WILLOW DR N
LONG LAKE, 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
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance, or if construction is
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
revoked at any time for due cause.
Applicant Permitee Signature Date
a
SEPTIC NEW
STATE SURCHARGE SEPTIC
TOTAL
SEPARATE PERMITS REQUIRED FOR WORK
By Signature t / /
ER THAN DESCRIBED ABOVE.
100.00
0.50
100.50
❑r