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• CITY OF ORONO * 2 0 1 2 - 0 1 0 5 9 * <br /> 2750 KELI,EY PARKWAY DATE ISSUED: 10/22/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2380 DEV[N LA <br /> PIN : 03-117-23-22-0013 <br /> LEGAL DESC : THE NURSERY <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : NEW <br /> ACT[VITY : MOUND SYSTEM -SEPT[C <br /> NO"I'l�:: (I)PRECAST CONCRG'I'E�IANK- 1,000 GALLON <br /> -380 S.F. <br /> 1`"'T'T r� ��r c�..� <br /> v <br /> APPLICANT SEPTIC NEW 200.00 <br /> PRIDE CONSTRUCTION& EXCAVATING STATE SURCHARGE SEPTIC 5.00 <br /> 9450 WEST HILL ROAD <br /> WATERTOWN, MN 55388 TOTAL 205.00 <br /> (952)475-2928 <br /> OWNER <br /> BLAUER, DARRELL W <br /> 2380 DEVIN LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> Stare Building Code. This permit is for only the work described and does <br /> not grant permission Yor 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 whethcr 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 /> suspendcd for a period of I 80 days at any[ime after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requeste in conformance w'th the S[a �Code.This permit may be <br /> rev � d at any time f r <br /> - /l� � Zz �/z `p ,aa, � <br /> Applican e itee igna ure Date Iss d L3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />