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�- ` CITY OF ORONO * Z 0 1 S - P1 1 0 9 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1205 FRENCH CREEK DR <br /> PIIY : 10-117-23-23-0001 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> ACTIVITY : OTHER-SEPTIC <br /> NOTE: PRESSURE BED SEPTIC SYSTEM <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> ELMER J. PETERSON COMPANY TOTAL 4U0.00 <br /> Payment(s) <br /> 5921 DAGUE AVE SE CHECK 19590 400.00 <br /> DELANO, MN 55328 <br /> (763)972-2420 <br /> Minnesota State License#: BUIL-219 <br /> OWNER <br /> WINSLOW, CLARK&SHARON <br /> 1205 FRENCH CREEK DR <br /> WAYZATA, MN 55391 <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 separate <br /> permits. AII 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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �'/ ���, �v // � <br /> Applican ermitee Signature Date �[ssued Signature Date <br />