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CITY OF ORONO * 2 0 1 7 — 0 0 9 6 6 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/21/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 540 WILLOW DR S <br /> PIN 03-117-23-32-0018 <br /> LEGAL DESC N/A <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE SEPTIC <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY SEPTIC(MOUND) <br /> NOTE: PRECAST CONCRETE TANKS 2250, 1300 <br /> NEW MOUND SEPTIC SYSTEMS <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> MATTER EXCAVATING TOTAL 400.00 <br /> 3710 CO.RD 21 <br /> Payment(s) <br /> MAYER,MN 55360- CHECK 5142 400.00 <br /> (612)6444587 <br /> Minnesota State License#:sept-L302 <br /> OWNER <br /> BOHLANDER,LAURA <br /> 2260 FOX ST <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 time for due cause. <br /> Applicant Permitee Signature Date Issued By ature Date <br />