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� � � CITY OF ORONO * 2 0 1 4 - 0 1 0 5 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/18/2014 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952)249-4616 <br /> ADDRESS : 3655 NORTH SHORE DR <br /> PIN : 08-117-23-34-0050 <br /> LEGAL DESC : CRYSTAL BEACH <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: WATER&SEWER CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> J P SCHMITZ CONSTRUCTION COMPANY LL STATE SURCHARGE SEWER&WATER 5.00 <br /> 16450 117TH AVE N <br /> MAPLE GROVE,MN 55369- TOTAL 105.00 <br /> Payment(s) <br /> CHECK 11794 105.00 <br /> OWIVER <br /> HAGEN,AL&DONNA <br /> 3655 NORTH SHORE DR <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cau <br /> I� - l� 9'� /S, <br /> Applic t P itee g ature Date Is d By Signature Date <br />