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CITY OF ORONO * z 0 1 6 - 0 0 4 2 4 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 06/07/2016 <br /> � ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2265 DEVIN LA <br /> PIN : 03-117-23-22-0018 <br /> LEGAL DESC : THE NURSERY <br /> : LOT 008 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(MOUND) <br /> NOTE: (3)EXISTING PRECAST CONCRETE 1'ANKS-EACH 1000 GALLON <br /> MOUND SYSTEM-500 S.F. <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> HAYES&SONS EXC. [NC. Payment(s) <br /> 263 82ND STREET S.E. CREDIT CARD 5293 400.00 <br /> MONTROSE, MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#: sept-L640 <br /> OWNER <br /> KOKAL, BRUCE&UTANE <br /> 2265 DEVIN LA <br /> LONG LAKE,I�4N 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 Ciry 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 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 construc[ion is <br /> suspended for a period of I80 days at any time after work has commenced. <br /> "I'he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be l <br /> revoked at any time for due cause. � �( !? <br /> � � � <br /> - ' -- rv � �f �L,�,� � ��,< ��� I,- � �1 � /�, <br /> Appl ant Pe i S' nature Date Issued By Signature Date <br />