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CITY OF ORONO PERMIT NO.: 2009-00580 <br /> � � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: 09/1 U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 200 BEDERWOOD DR <br /> PIN : OS-117-23-12-0027 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> CONCRETE SCIENCE SERVICES WATER CONNECT/DISCONNECT/REPAIR 0.00 <br /> 7545 COMMERCE ST. WEST <br /> CORCORAN,MN 55340- STATE SURCHARGE SEWER&WATER 0.50 <br /> (763)420-4073 TOTAL 50.50 <br /> OWNER <br /> AZAD, ALISHAH <br /> 200 BEDERWOOD DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I80 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 responsible for assuring aIl 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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Si ture <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB V . <br />