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� ' CITY OF ORONO * Z pJ 1 7 - 0 PJ 3 1 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/04/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2732 CAROLINE AVE <br /> PIN : 20-117-23-24-0041 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1451 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SF,WER AND WATER CONNECTION <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> CHUCK'S EXCAVATING WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> 760 WEST 96TH STREET STATE SURCHARGE SEWER&WATER 1.00 <br /> CHANHASSEN,MN 55317- TOTAL 101.00 <br /> (952)496-2874 Payment(s) <br /> Minnesota State License#: SW-L3320 CHECK 5921 141.00 <br /> OWNER <br /> LUND, ROBERT <br /> 2732 CAROLINE AVE <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 goveming 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time afrer 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 /> �- /� �.�� '� � � � �7 <br /> Appl' nt Permitee Signature Date Issued By ignature Date <br />