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• PERMIT <br /> CITY OF ORONO <br /> 2750 Kelley Parkway - PO Box 66 Permit Number: Pogsio <br /> Crystal Bay, Minnesota 55323 Permit Type: seWer ana water Pe�t <br /> (952) 249-4600 Date Issued: 3iioi2oos <br /> SITE ADDRESS: 781 Boulder Dr <br /> Long Lake,MN 55356 <br /> PID: 33-118-23-11-0008 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Permit Class: General <br /> Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer&Water Connections <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: <br /> NOTICES/REMARKS: <br /> SAC Paid#P07987- 11/09/04 <br /> FEE SUMMARY: Permit Fee: $ 70.00 <br /> Valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> TOTAL FEE: $ 70.50 <br /> APPLICANT: Westonka Sewer&Water OWNER: Dahlstrom Development LLC <br /> 6501 Co. Rd 15 7745 Polaris Lane <br /> Mound,MN 55364 Maple Grove,MN 55311 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> � <br /> i, <br /> � I�.�.�-l. c (�''YlC't <� /Z/� <br /> PPLICANT PERMITEE SIGNATURE ISSUGD I3Y SIGNATtJRE <br /> Copies: 1-File(Sienitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 <br />