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r <br /> � CITY OF ORONO � 0 1 6 - 0 0 6 4 2 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 06/06/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1400 BALDUR PARK RD <br /> PI I� : 08-117-23-31-0001 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT O15 BLOCK OOl <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION-4"PIPE, SCH.40 <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> WESTONKA SEWER& WATER TOTAL 51.00 <br /> 6501 CO. RD 15 Payment(s) <br /> MOLIND, MN 55364 51.00 <br /> (952)472-4959 <br /> Minnesota State License#: BUIL-1804 <br /> OWNER <br /> ELLIOT"I', STEVE <br /> 1400 BALDUR PARK RD <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 specitications,applicable City approvals,and the <br /> State E3uilding 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. 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 authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 18o days at any time afrer 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 a�time for due cause. r <br /> � <br /> � -�_ O �l � � � � I� <br /> Ap icant Permi gnat e Date Issued Signature Date <br />