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, _ CITY OF ORONO * 2 0 1 3 - 0 0 9 9 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/25/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3227 CASCO CIR <br /> PIN : 20-117-23-43-0018 <br /> LEGAL DESC : SPRING PARK <br /> : LOT 026 BLOCK 000 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTF,: SGWER AND WATER DISCONNECT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> D.S.M. EXCAVATING WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 2916 ENTERPRISE AVE <br /> HASTINGS, MN 55033- STATE SURCHARGE SEWER& WATER 5.00 <br /> (651)480-1355 TOTAL 105.00 <br /> PAID WITH CC# 9252 <br /> OWNER <br /> O'ROURKE, JAMES <br /> 3227 CASCO CIR <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[he 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 au[horized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time after work has commenced. <br /> "�he 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 at any ti e for due cause. � <br /> �° � � a.s � l3 ��,���� �' ��-i � > <br /> Applicant Permitee Signature Date Issued, �y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />