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CITY OF ORONO * 2 0 1 7 - 0 0 5 5 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/23/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2510 CASCO POINT RD <br /> PIN : 20-117-23-21-0016 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 004 BLOCK 006 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER AND WATER DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> OLSON CONSTRUCTION EXCAVATION CO. STATE SURCHARGE SEWER&WATER 1.00 <br /> 6970 INWOOD ROAD <br /> COLOGNE,MN 55322- TOTAL 101.00 <br /> (952)448-6674 Payment(s) <br /> Minnesota State License#:cont-L1111 CREDIT CARD 3469 101.00 <br /> OWNER <br /> HART,MICHAEL&KRISTIN <br /> 2510 CASCO PT RD <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 l80 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 /> C�-�.t_a�c..��c�� �o L <br /> Applicant Permitee Signature Date Issued Signature Date <br />