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� CITY OF ORONO * Z 0 1 5 - 0 1 5 4 4 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: 12/10/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3185 CASCO CIR <br /> PIN : 20-117-23-43-0024 <br /> LEGAL DESC : SPRING PARK <br /> : LOT 034 BLOCK 000 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: WATER&SEWER DISCONNECT <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN SEWER&WATER WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> 864 QUAIL PKWY STATE SURCHARGE SEWER&WATER 1.00 <br /> WATERTOWN,MN 55388- TOTAL 101.00 <br /> Minnesota State License#: SW-57329MR Payment(s) <br /> CHECK 4730 101.00 <br /> OWNER <br /> YAFFE,HARRY&BELLE <br /> 2300 ARCHERS LA <br /> MINNETONKA, MN 55305- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his permi[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. AII 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 I80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any[ime 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 /> /�. � �� �v /a-, /� �/5 <br /> Applicant Permitee ignature � Date Issued 'gnature Date <br />