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CITY OF ORONO PERMIT NO.: 2009-00706 <br /> t 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/14/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 102 CHEVY CHASE DR <br /> PIN : 36-118-23-41-0031 <br /> LEGAL DESC HILL O'WAY MANOR <br /> LOT 026 BLOCK 001 <br /> PERMIT TYPE SEWER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE REPAIR <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> GROTH SEWER& WATER STATE SURCHARGE FLAT-OTHER 0.50 <br /> 775 TOWER DRIVE <br /> HAMEL, MN 55340- TOTAL 50.50 <br /> (763)478-6712 PAID WITH CASH 50.50 <br /> Minnesota State License#: 058606-PM <br /> OWNER <br /> YOKIEL, SCOTT&JENNIFER <br /> 102 CHEVY CHASE DR <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 /> revoked at any time for due pa se. <br /> ApAa tfPeimit Signature Date Issued By Sig ure ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />