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�' � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 8 - 0 0 0 0 3 * <br /> DATE ISSUED: OUO2/2018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1720 SHADYWOOD RD <br /> PIN : 17-117-23-21-0019 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: WATER AND SEWER CONNECTION <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> BOLLIG&SONS,INC. STATE SURCHARGE SEWER&WATER 1.00 <br /> 11401 COLJNTY ROAD 3 <br /> HOPKINS,MN 55343- TOTAL 101.00 <br /> (952)93&4133 Payment(s) <br /> CREDIT CARD 9081 101.00 <br /> OWNER <br /> HANSBERGER,TRAVIS <br /> 651 LEXIE CT <br /> EAGAN,MN 55123- <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 dces <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 ime after work has commenced. <br /> The applicant is re nsible for ass g all required inspections aze <br /> requested in co o ance with tate Building Code.This pennit may be <br /> revoked at ' e for due ca e. <br /> ��-Z- � 6 � � �l�'' <br /> �� D <br /> Applicant Permitee Signature Date Issued B ignature Date <br />