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CITY OF ORONO * z 0 1 7 - 0 1 3 3 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/24/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1760 SHORELINE DR <br /> PIN : 10-117-23-14-0017 <br /> LEGAL DESC : N/A <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> NOTE: (1)PRECAST CONCRETE TANK- 2250 SEPTIC TANK <br /> (1) 1300 PUMP CHAMBER <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> J S STEWART COMPANIES, INC. Payment(s) <br /> 11030 LAMONT AVE NE CHECK 8014 400.00 <br /> HANOVER,MN 55341 <br /> �) <br /> Minnesota State License#:sept-L703 <br /> O W NER <br /> Woodhouse Shoreline LLC <br /> 600 HIGHWAY 169 S#701 <br /> MINNEAPOLIS,MN 55426- <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 addi[ional or related work which requires separate <br /> permits. AII 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 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 /> ��-�it���� � ' � �' ���--L "�� /� �d� l 7 <br /> Applicant Permitee Signature Date Issued B ignature Date <br />