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a <br />PERMIT <br />CITY OF ORONO PERMIT TYPE: 0004572% wATE <br />1335 Brown Rd. South • P.O. Box 66 Permit Number: <br />Crystal Bay, Minnesota 55323 Date Issued: <br />(612) 47 -7357 <br />3 <br />SITE ADDRESS: 2 580 FOX ST <br />DESCRIPTION: <br />Sewer & Water Permit T;,PE WELL <br />Sewer & Water Work Type RESIDENCE <br />FEE SUMMARY: <br />Ease Fei, $ . 00 WELL $:::U . UG <br />Surcharge MAIL IN--------_-1��4 <br />Subtotal $.SA Total Fee $32.00 <br />CONTRACTOR: -- APP l lic ant. - OWNER: <br />B RG_RSON G •SWELL INC 4479:3121 PAR N_ '3 4 DESIGN <br />b] 1 b INDUSTRIAL �:T EAST LAKE ST <br />MAPLE PLAIN MN 75:359 WAYZATA MN SS:391 <br />(612.) 47.E-"�:121 476-4444 <br />R I TE FtIJ': i BE OK' 0 BY CITY "STAFF . SUBMIT COPY OF STATE WFLL RECORD. <br />,r THE UNDERSIGNED HEREBY REQUESTS PERMISSION 10 MAKE THE REAL IMPROVEMENTS <br />SPECIFIED AND AGREES TO 00 ALL WORK IN 'STRICT COMPLIANCE WITH ALL CITY OF <br />(_ OW*Ki ORD I NANC:E S AND STATE. OF M I NNE SOTA BU 1 LD 1 NG CODE REQUIREMENTS. <br />APPLICANT PERMITEE SIGNATURE ISS BY SIGNATU4 <br />