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,� �" CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 P1 1 4 - P1 0 5 3 8 * <br /> DATE ISSUED: 06/02/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2524 SANDSTONE LA <br /> PIN : 33-118-23-11-OO19 <br /> LEGAL DESC : STONEBAY <br /> : LOT 016 BLOCK 001 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BOLLIG & SONS, INC. STATE SURCHARGE SEWER& WATER 5.00 <br /> 1 1401 COUNTY ROAD 3 TOTAL 105.00 <br /> HOPKINS, MN <br /> (612)938-4433 Payment(s) <br /> CHECK 8719 ]05.00 <br /> OWNER <br /> Stonebrook Homes <br /> 1016 COVETRY PL <br /> ED1NA, MN 55424- <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 gran[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 wi[hin 180 days of the date of issuance,or if construction is <br /> suspended Yor 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 /> �-z - (�-% � � <br /> pplicant Permitee Signature Date Issued By i ature Date <br />