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� ' CITY OF ORONO * z � 1 7 - � 1 z 6 � * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/04/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 565 SANDHILL DR <br /> PIN : 33-118-23-24-0012 <br /> LEGAL DESC : ORONO PRESERVE <br /> : LOT 5 BLOCK 1 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER AND WATER CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> D.S.M. EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 <br /> 2916 ENTERPRISE AVE <br /> HASTINGS,MN 55033- S.A.C. 0.00 <br /> (651)480-1355 TOTAL 101.00 <br /> Payment(s) <br /> CREDIT CARD 5166 101.00 <br /> OWNER <br /> OPS Orono LLC <br /> 15250 WAYZATA BLVD#101 <br /> WAYZATA,MN 55391- <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 goveming 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 l80 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 /> � ,� �% / � �-- � 1 U l `� l l/ <br /> Applic n Permitee Signature Date Iss d By Signature Date <br />