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CITY OF ORONO * 2 0 1 4 - 00 -702 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/16/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2360 WILLOW HILL DR <br /> PIN : 03-117-23-23-0023 <br /> LEGAL DESC : WILLOW HILL <br /> : LOT 3 BLOCK 1 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM- SEPTIC <br /> NOTE: DARWIN PRECAST CONCRETE TANKS(3) 1300 GALLON <br /> MOUND 36 X 83 S.F. <br /> APPLICANT SEPTIC NEW 200.00 <br /> BURNS EXCAVATING, INC. STATE SURCHARGE SEPTIC 5.00 <br /> 3470 CO. RD 21 TOTAL 205.00 <br /> MAYER, MN 55360- Payment(s) <br /> (612)685-4303 CHECK 25528 205.00 <br /> Minnesota State License#: SW-1888 <br /> OWNER <br /> BATA,JEFF& PAULA <br /> 19000 31ST PLACE N <br /> PLYMOUTH, MN 55447- <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 he <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Si ure )ate <br />