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CITY OF ORONO PERMIT NO.: 2010-00837 <br /> • � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/14/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3382 BAYSIDE RD <br /> PIN : OS-117-23-14-0035 <br /> LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK <br /> : LOT 009 BLOCK 005 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: <br /> SEWER DISCONNECTION-4" PIPE S1ZE <br /> APPLICANT SEWER CONNECT/D[SCONNECT/REPAIR 50.00 <br /> DASEN CO. STATE SURCHARGE SEWER& WATER 5.00 <br /> 24245 NATCHEZ TOTAL 55.00 <br /> LAKEVILLE, MN 55044- <br /> (952)461-2100 PAID W[TH CC# 7883 <br /> Minnesota State License#: 1612 <br /> OWNER <br /> HUTHWAITE, MICHAEL& MARILYN <br /> 7715 A[NSWORTH DR <br /> GERMANTOWN, TN 38138- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall be performed according to <br /> thc 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 I 80 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 respo le for assuring all required inspections are <br /> requested in conf a e it e Quilding Code.This permit may be <br /> revoked at an ime o c s <br /> � �/ /// ��/ �j /�--� /C) <br /> Ap �c t Permitee ignature Date �s By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />