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L <br /> } ' CITY OF ORONO PERMIT NO.: 2010-00117 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE [SSUEu: 03/03/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1785 CONCORDIA ST <br /> PIN : 17-117-23-22-0016 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NO"I�E: CREDIT"I'O l3E ISSUED PGR CI IAR'I'(RD&BGS) <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> UP NORTH MECHANICAL WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 43900 ELMCREST AVE <br /> P.O. BOX 35 STATE SURCHARGE SEWER& WATER 0.50 <br /> HARRIS, MN 55032 S.A.C. 0.00 <br /> (651)277-0515 MISC FEE 0.00 <br /> TOTAL ]00.50 <br /> OWNER <br /> DULIN, KEVIN & BARBARA <br /> 1785 CONCORDIA 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 Cit�approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional ar related work which requires separatc <br /> permits. All provisions oflaws and ordinances governing this type ofwork <br /> shall be compied with�chether 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 are <br /> requestec�i�conformance�vith the State Building Code.This permit may be <br /> rev �at any ti � _duc c�use. <br /> ��i' / <br /> l l �7YV�-Q'rL l l <br /> Appli t Permitee Signaturc Date [ssued E3y � nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />