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,� �` CITY OF ORONO PERMIT NO.: 20�2-000i9 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DA'rE ISSUEn: OU10/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3572 LIVINGSTON AVE <br /> PIN : 17-117-23-43-0150 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 000 BLOCK 003 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTf: WATER AND SEWER DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> MIKIES LANDSCAPING WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 11039 COLINTY RD 16 <br /> WATERTOWN, MN 55388- STATE SURCHARGE SEWER&WATER 5.00 <br /> (612)221-3657 TOTAL 105.00 <br /> OWNER <br /> CUFF, MARK& KAREN <br /> 3572 LIVINGSTON 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 specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission 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 speeified 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 /> reques[ed in co formance with th State Building Code.This permit may be <br /> rev� t an me f ue ca <br /> � �. � / / / l /O l /d-- <br /> Applicant Permitee Sig a ure Date <br /> ssued y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />