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` ' CITY OF ORONO * Z 0 1 6 - PJ 0 6 6 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/22/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 755 FERNDALE RD N <br /> PIN : 36-118-23-11-0028 <br /> LEGAL DESC : LYDIARD HILLS <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(PRESSURE BED) <br /> NOTE: OTHER INSPECTION NOTED: PUMP AND ALARM <br /> MISC FEE: M[D LEVEL INSPECTOR REQUIRED <br /> NOTE: NEED MANAGEMENT PLAN SIGNED BY OWNER OR BUYER. CONTACT BRIAN HUMPAL FOR ALL INSPECTIONS AT <br /> 651-492-7550 <br /> APPLICANT SFPTIC NEW OR REPLACEMENT 400.00 <br /> MISC FEE 510.00 <br /> KOTHRADE SEWER&WATER TOTAL 910.00 <br /> 12059 WHITETAIL AVENUE <br /> HANOVER,MN 55341 Payment(s) <br /> CREDIT CARD 4122 910.00 <br /> �) <br /> Minnesota State License#:pibg-RP645681 <br /> OWNER <br /> MITHUN,JEANNE <br /> 755 FERNDALE RD N <br /> WAYZATA, MN 55391- <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 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 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 /> The 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 /> L��� (`� � p i�i O <br /> �� �� <br /> Applicant Permitee Signature Date Issued B ignature Date <br />