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� � CITY OF ORONO * z 0 1 5 - 0 0 8 8 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/16/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2470 CARMAN ST <br /> Pllv : 20-117-23-12-0066 <br /> LEGAL DESC : LEHMAN LAGOON <br /> : LOT 1 BLOCK 1 <br /> PERM[T TYPE : WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: NEW WATER CONNECTION <br /> APPLICANT WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER& WATER 1.00 <br /> GEOTECHNOLOGY LLC TOTAL 51.00 <br /> 19049 ORCHARD TRAIL Payment(s) <br /> LAKEVILLE,MN 55044- CHECK 10615 51.00 <br /> OWNER <br /> JARNES,JEFF&JACQ <br /> 2470 CARMAN 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 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 I 80 days of the date of issuance,or if construc[ion is <br /> suspended for a period of 180 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the Sta[e Building Code.This permit may be <br /> revoked t any time for due cause. . <br /> � <br /> , � ��'� ���� ' �7��� ��i-� D -C�,�"s� � l � � <br /> Applicant P itee Signature Date Iss ed Signature Date <br />