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CITY OF ORONO PERMIT NO.: 2011-00413 <br /> f 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/06/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS` 450 WILLOW DR S <br /> PIN 03-117-23-32-0012 <br /> LEGAL DESC UNPLATTED 03 117 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: MOUND SYSTEM-PRESSURE BED-900 S.F. <br /> (3)PRECAST CONCRETE TANKS EACH 1,000 GALLONS <br /> BE REMINDFUL ON DEPTH OF SYSTEM <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES&SONS EXC. INC. STATE SURCHARGE SEPTIC 5.00 <br /> 263 82ND STREET S.E. <br /> MONTROSE,MN 55303- TOTAL 205.00 <br /> (763)479-1762 PAID WITH CC# 5293 <br /> Minnesota State License#:640 <br /> OWNER <br /> BOWMAN,WILLIAM <br /> 450 WILLOW DR S <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 /> e y e r de cause. <br /> A plicant Perkio6 Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />