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CITY OF ORONO I• 111111111V' I III � � 1111111 <br /> 1 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/19/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 460 ORCHARD PARK RD <br /> PIN : 32-118-23-23-0012 <br /> LEGAL DESC : ORCHARD FARMS <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(MOUND) <br /> NOTE: (2)PRECAST CONCRETE TANKS <br /> 2250 AND 1300 <br /> NEW MOUND SYSTEM <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> BURNS EXCAVATING,INC. Payment(s) <br /> 3470 CO. RD 21 CHECK 28013 400.00 <br /> MAYER,MN 55360- <br /> (612)685-4303 <br /> Minnesota State License#: SW-1888 <br /> OWNER <br /> MULHERAN,PATRICK&MELISSA <br /> 4128 HALLGREN LA <br /> EXCELSIOR,MN 55331- <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 /> k../0 5Le/) `IS o <br /> Applicant Permitee Signature Date Issued By Signature Date <br />