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CITY OF ORONO * Z 0 1 5 - 0 0 S 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/09/2015 <br /> � � ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1340 FOX ST <br /> PIN : 02-117-23-31-0056 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT MB BLOCK 14 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECT[ON <br /> NOTE: SAC PAID#6446 09/02/1981 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> COPPIN SEWER&WATER STATE SURCHARGE SEWER& WATER 1.00 <br /> 864 QUAIL PKWY TOTAL 51.00 <br /> WATERTOWN, MN 55388- Payment(s) <br /> Minnesota State License#: SW-57329MR CHECK 4526 51.00 <br /> OWNER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLAIN COURT <br /> EDEN PRAIR[E, MN 55344- <br /> AGREEMENT AI�ID SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <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 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections ace <br /> requested in conformance with the State Building Code.This permit may be ' � <br /> revoked at any time for due cause. ���� <br /> ) i <br /> . � �� � � <br /> /1 • � _" -: '� `. <br /> ; _ . ,. �� � � l� -� �� - / / <br /> Applicant Permite�Sign ure Date Issued By Sig ature Date <br />