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CITY OF ORONO * z 0 1 5 - 0 1 3� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2015 <br /> � ORONO, MN 55356- <br /> - 952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 1224 BRIAR ST <br /> PIN : 10-117-23-31-0074 <br /> LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE <br /> ; LOT 000 BLOCK 002 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SAC PAID#8279 OUO2/1986 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> TUMA CONSTRUCTION TOTAL 51.00 <br /> 5045 COUNTY ROAD 19 <br /> M[NNETRISTA,MN 55359- Payment(s) <br /> (763)479-2982 CHECK 4679 51.00 <br /> Minnesota State License#: BUIL-PB695614 <br /> OWNER <br /> HILLIER,JAMES <br /> 1224 BRIAR ST <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 80 days of t date of issuance,or if construc[ion is <br /> suspended for a r od of 18 ay at any time r wor a�rnenced. <br /> The applicant' r ponsib for s�ci�- r red inspections are <br /> requested in o ormanc wit he S[ate Bu' ' g Code.This permit may be �7��7 <br /> revoked at ime for ue ause. � <br /> �G-z�-l�� �� �� �- <br /> ����1 �' ��� � (�� � 3� ! <br /> Appl cant Permitee Signature Date Issued By Signature Date <br />