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. • CITY OF ORONO * 2 0 1 4 - 0 1 2 4 Z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/29/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 440 BIG ISLAND <br /> PIN : 23-117-23-32-0078 <br /> LEGAL DESC : BIG ISLAND <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM - SEPTIC <br /> NOTE: NEW SEPTIC SYSTEM <br /> APPLICANT SEPTIC NEW 200.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> BURNS EXCAVA'T'ING, INC. <br /> 3470 CO. RD 21 TOTAL 205.00 <br /> MAYER, MN 55360- Payment(s) <br /> (612)685-4303 CH�:'CK 25415 205.00 <br /> Minnesota State License#: SW-1888 <br /> OWNER <br /> REIMANN, JOHN &ALICE <br /> 21957 MINNETONKA BLVD#12 <br /> EXCELSIOR, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for�vhich 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 thc 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."I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days u1�the date of issuance,or if construction is <br /> suspended for a period of� 180 days at any time after��ork has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the Stale Building Code.'This permit may be <br /> revoked at am�time for due cause. <br /> y� r .. .__ . J� �j <br /> J � V l �! l� <br /> Applicant Permitee Signature Dale Issued By Signature Datc <br />