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CITY OF ORONO PERMIT NO.: 2010-00229 <br /> 1 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 04/14/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 4655 TONKAVIEW LA <br /> PIN 07-117-23-32-0064 <br /> LEGAL DESC N/A <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE SEWER&WATER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE CONNECTION <br /> NOTE: SAC GRANDFATHERED IN-RECLAIM DEMO CREDIT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BORN WELL DRILLING CO. <br /> 16550 BASELINE AVE. STATE SURCHARGE SEWER&WATER 0.50 SHAKOPEE,MN 55379 TOTAL 50.50 <br /> (952)445-4809 <br /> Minnesota State License#: 1043 <br /> OWNER <br /> LICURSI,ANGELO&RACHEL <br /> 17601 70TH PLACE N <br /> MAPLE GROVE,MN 55311- <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 or due cause. <br /> 911y"'110 <br /> pplicant Permitee Signature Date Issued ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV <br />