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CITY OF ORONO * 2 0 1 6 - 0 1 0 7 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/3U2016 <br /> � ORONO, MN 55356- <br /> " (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1240 ARBOR ST <br /> PIN : 10-117-23-31-0099 <br /> LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER CONNECTION <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 <br /> MOUND,MN 55364 Payment(s) <br /> 51.00 <br /> (952)472-4959 <br /> Minnesota State License#: BUIL-1804 <br /> OWNER <br /> DRUK,TIMOTHY&JULIE <br /> 4308 115TH STREET SE <br /> DELANO, MN 55328- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and speci6cations,applicable City approvals,and Ihe <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 conshuction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The appiicant is responsible for assu all required inspections are <br /> requested in conformance with the ta e Building Code.This permit may be � „ ti�� <br /> revoked at any time for d caus i � <br /> 7 ) �.,� V l� <br /> "�=% � % �- �l- � � � I� �-�-�-J �' � � 1 <br /> /` ='� , � � `---'�- � � <br /> �pli rmite gnature Date Issued By Sign ure Date <br />