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CITY OF ORONO I11(3111H 11111II1111111ll 1111I1IH11111E11 <br /> * 2 0 1 5 - 0 1 4 2 4 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 11/04/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 450 OLD CRYSTAL BAY RD NFLA <br /> PIN : 33-118-23-13-0020 <br /> LEGAL DESC : CRYSTAL BAY BUSINESS CENTER 2ND ADD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTOIN <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> GROTH SEWER&WATER STATE SURCHARGE SEWER&WATER 1.00 <br /> 775 TOWER DRIVE TOTAL 51.00 <br /> HAMEL,MN 55340- Payment(s) <br /> (763)478-6712 CHECK 16635 51.00 <br /> OWNER <br /> Jem Technical <br /> 450 OLD CRYSTAL BAY RD N <br /> LONG LAKE,MN 55356- <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 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 /> .1111,i <br /> A ant P rmitee S': .ti'e Date Issued :ijignature Date <br />