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P . '. <br /> CITY OF ORONO � 0�0 0 9 z 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/04/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1830 SHORELINE DR <br /> PIN : ]0-117-23-42-0002 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. 356 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NO"1'F,: SEWER CONNGCTION-4"PIPE-PVC MATERIAL <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN SEWER&WATER STATE SURCHARGE SEWER& WATER 1.00 <br /> 864 QUAIL PKWY TOTAL S1.00 <br /> WATERTOWN, MN 55388- Payment(s) <br /> (6l2)508-9974 CHECK 5013 51.00 <br /> Minnesota State License#: SW-57329MR <br /> OWNER <br /> TUFAA&NEDIYO SADO,TASHITTA <br /> 1224 CEDAR POINTE DR N <br /> MINNETONKA, MN 55305- <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 rela[ed 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 becon�e 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 /> �' �� 5-�1- I�c ��� � E'�� ��C� �' <br /> `�-V. � � � C � i ,� <br /> Applicant �rm�tee ignat e Date Issued;B} ignature Date <br /> : ; <br />