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CITY OF ORONO PERMIT NO.: 2008-00069 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/23/2008 <br /> (952)249-4600 FAX: (952) 249-4616 P/A A b <br /> ADDRESS : 1020 WILLOW DR N <br /> PIN : 27-118-23-32-0022 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> APPLICANT <br /> SEPTIC NEW 100.00 <br /> PA BROS STATE SURCHARGE SEPTIC 0.50 <br /> 2320000 109 109TH AVE <br /> ROGERS,MN 55374 TOTAL 100.50 <br /> (763)428-7393 <br /> Minnesota State License#: 95 <br /> OWNER <br /> COX,JAMES&BERADINE <br /> 1020 WILLOW DR N <br /> LONG LAKE,MN 55356 <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 any ' e for due'. .e. <br /> Applicant Permitee ignature Date i 7/ 30 15 <br /> sZ ]�Signature "41/ Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A:OVE. <br />