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CITY OF ORONO * Z 0 1 5 - 0 0 5 2 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/04/2015 <br /> . ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 763 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0091 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 4 BLOCK 1 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC PAID#2015-00094 04/20/15 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BOLLIG&SONS, INC. STATE SURCHARGE SEWER&WATER 5.00 <br /> 11401 COCJNTY ROAD 3 <br /> HOPKINS,MN TOTAL 105.00 <br /> (612)938-4433 Payment(s) <br /> CREDIT CARD 9081 105.00 <br /> OWNER <br /> Stonebrook Development LLC <br /> 6117 BLUE CIRCLE DRIVE <br /> MINNETONKA,MN 55343- <br /> AGREEMENT AIVD 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 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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked t any time for due cause. `1« <br /> _ ,�� � (r�'VL���7 � � � � � <br /> plicant Permitee Signature Date [ssued By Signature Date <br />