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CITYOFORONO * Z012 - 00295 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 04/18/2012 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 70 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0018 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0446 <br /> : LOT 000 BLOCK 000 '�' � � �•�� ���.� <br /> �3�t; i��e�iey P�rlw�p <br /> PERMIT TYPE : WATER �p� � �5� , jG;_ �;_-��Esv_: <br /> PROPERTY TYPE : RESIDENTIAL ��1 � �� �.��� , - <br /> CONSTRUCTION TYPE : PASS THROUGH FEES � � <br /> #�s's <br /> NOTE: THIS IS THE WATER CONNECTION FEE FOR PERMIT# <br /> SEWER CONNECTION&SAC WAS ON PGRMIT# P�evi4Us.balaYrcg; ^, ,�� <br /> QLri[k�5 <br /> 7fJ Myrtlewwa',d �d` Da�S ' :�,lc�.t�' <br /> PAID VIA:CK#125 ZOE SWANSON ��,�� F�, a , <br /> 1�I-�,48Ui <br /> l��yzata Nti�?Swr`Ca�nneetio�r:!�ee <br /> ,�'sal; --- �"�,ti�2.[�ti <br /> t _��r.. <br /> -�c !�lo: IiS, , . ` 2f'�22.#�D <br /> �f: <br /> �:�'!.�i1�UR <br /> Nr�p��: �,��v i.� <br /> � h.r:u;Y-w_w <br /> ��ldtt�p iEt1{ik1"E�: " •,-'��� <br /> ¢ --a��z v. <br /> �F�?8��i4 1`�;;.�i.r�, , <br /> APPLICANT WATER CONNECT[ON CHARGE-WAYZATA 2,122.00 <br /> SWANSON, JOSEPH TOTAL 2,122.00 <br /> 70 MYRTLEWOOD RD <br /> WAYZATA, MN 55391- <br /> OWNER <br /> SWANSON,JOSEPH <br /> 70 MYRTLEWOOD RD <br /> WAYZATA, MN 55391- <br /> AGREEME1vT 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 /> pemiits. 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 180 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 /> il� i � i l <br /> Applic Permitee Signature Date Issued By nature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />