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CITY OF ORONO * z 0 1 2 — 0 0 8 4 Z * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: O8/27/2012 <br /> , ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3980 DAHL RD <br /> PIN : 08-117-23-23-0001 <br /> LEGAL DESC : LJNPLATTED 08 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> J.S. STEWART COMPANIES STATE SURCHARGE SEWER& WATER 5.00 <br /> 11099 LAMONT AVE <br /> HANOVER, MN 55341 MAIL-IN FEE 2.00 <br /> (763)424-9030 TOTAL 57.00 <br /> OWNER <br /> MCGLYNN, THOMAS& TONI <br /> 3980 DAHL RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. "I'his 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 no[specitied 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 /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> l�l'11Q�c�. � / / / / <br /> Applicant Permilee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED AB . <br />