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CITY OF ORONO PERMIT NO.: 2oii-o�4g� <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/02/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4010 BAYSIDE RD <br /> PIN : 06-117-23-11-0006 <br /> LEGAL DESC : POPOV ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> NOTE: (2)PRECAS"C CONCRETE TANKS- 1�00 GALLON TANKS- 1000 GAL DUMP SYSTEM <br /> MOUND SYSTEM-�0 X 25 S.F. <br /> APPLICANT <br /> SEPTIC NEW 200.00 <br /> RON OLSON CONSTRUCTION STATE SURCHARGE SEPTIC 5.00 <br /> 2950 IN WOOD ROAD <br /> COLOGNE, MN 55422- TOTAL 205.00 <br /> (612)310-7887 <br /> Minnesota State License#: L11 ll <br /> OWNER <br /> LEVANG,CURTIS& ELIZABETH <br /> 4010 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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 govcrning this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 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 /> �I�he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. - <br /> �- � ��- 02� / <br /> Applicant Permitee Signature �e ssued Signature Date <br /> Z <br /> SEPARATE PERMITS E IRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />