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P CITY OF ORONO PERMIT NO.: 2010-00612 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 08/06/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 920 WAYZATA BLVD W <br /> PIN : 35-118-23-41-0006 <br /> LEGAL DESC : UNPLATTED 35 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: (3)PRECAST CONCRETE, 1000 GALLON TANKS <br /> MOUND SYSTEM-380 S.F. <br /> WELL MUST BE ABANDONED OR VARIANCE OBTAINED FROM M.D.H. <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES&SONS EXC.INC. STATE SURCHARGE SEPTIC 5.00 <br /> 263 82ND STREET S.E. TOTAL 205.00 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 PAID WITH CC# 5293 <br /> Minnesota State License#: 640 <br /> OWNER <br /> CHIODIAN,HEATHER&MICHEAL <br /> 920 WAYZATA BLVD W <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 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 /> re ..-d. any tim- for due cause. / <br /> �► / .// / fD / l / tet_ j,/ 3)3/1° <br /> e /U <br /> pplic. ;<!' itee Signature DateIssued By Signature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />