HomeMy WebLinkAbout2010-00120 - water pass through fees CITY OF ORONO PERMIT NO.: 2oiaooi2o
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 03/03/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 50 MYRTLEWOOD RD
PIN : 36-118-23-33-0006
LEGAL DESC : REG. LAND SURVEY NO.0446 .
: LOT 000 BLOCK 000
PERMIT TYPE : WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : PASS THROUGH FEES
NOTE: THIS IS FOR ADDTIONAL$100 FEE FOR PASS THRU TO WAYZATA FOR NEW 2010 RATE. ORIGINAL PERMIT 2009-00922
WAS ISSUED IN 2009 BUT THE PROJECT WASN'T COMPLETED UNTIL 2010.
APPLICANT WATER CONNECTION CHARGE-WAYZATA 100.00
CHAMPLIN,MR.&MRS. TOTAL 100.00
50 MYRTLEWOOD RD
WAYZATA,MN 55391-
OWNER
CHAMPLIN,MR.&MRS.
50 MYRTLEWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.