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CITY OF ORONO * 2 0 1 5 - 0 1 0 1 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/17/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2740 DEER RUN TR E <br /> PIN : 04-117-23-13-0010 <br /> LEGAL DESC : N/A <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIv TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: MOUND - 10 X 62.5 S.F. <br /> 2- 1500 GALLON TANKS EXISTING <br /> 1 - 1500 PUMP TANK <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> PATNODE BROTHERS INC. TOTAL 400.00 <br /> 2841 LANDER AVE Payment(s) <br /> CREDIT CARD 5822 400.00 <br /> ST. MICHEAL,MN 55376- <br /> (612)919-0112 <br /> Minnesota State License#: sept-L3843 <br /> OWNER <br /> LARKIN, BRIAN& SUSAN <br /> 2740 DEER RUN TR E <br /> LONG LAKE, MN 55356 <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 the work described and does <br /> not grant permission for additional or related work which requires sepazate <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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> -- ' ' <br /> � <br /> � �%�- / � / ' _� � � /� <br /> � i ��i <br /> Applicant Permitee Signature Date Issued ignature Date <br />