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..,; .: <br /> CITY OF ORONO * 2 0 1 4 - 0 0 5 4 2 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 06/02/2014 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1645 BOHNS POIN'T' RD <br /> PIN : 17-117-23-11-0007 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0565 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : RE-CONNECT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> UNLIM[TED, INC. <br /> 19960 ST FRANCIS BLVD TOTAL 55.00 <br /> ANOKA, MN 55303- Payment(s) <br /> (763)753-9867 CHECK 1008 55.00 <br /> OWNER <br /> CHURCH,JOHN& KLERISSA <br /> 1645 BOHNS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this perniit is issued shall be perlormed 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 /> pennits. 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 180 days o�the date of issuance,or if construction is <br /> suspended for a period of 1 days at any[ime after work has commenced. <br /> I he applicant is respons e for assuring all required inspections are <br /> requested in conform�e with the State Building Code.This permit may be <br /> revoked at any time,.�fr due cause. <br /> /� � <br /> �,�:�� �� �'^� ��0��� / / <br /> Applica(t��P m�tee ignature Date Issued By gnature Date <br />