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�-�` '' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 3 - 0 0 4 3 4 * <br /> DATE ISSUED: 06/03/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTED ON 6/3/2013 <br /> ADDRESS : 55 GOLDEN VIEW DR <br /> PIN : 33-118-23-43-0011 <br /> LEGAL DESC : PETERMAN 2ND ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> NOTE: (3)PRECAST TANKS <br /> RGUSE EXISTING TANKS IF WATER T[GH'I�. IF NOT,(2)USE NEW 1300 GALLON TANKS AND(1)NEW 1300 GALLON <br /> PUMP TANK. <br /> MOUND TREATMENT SYS"['EM-630 SQUARE FEE"I <br /> SOILS NEED TO BE VERIFIF,D BEFORE INSTALLA"I ION. <br /> APPLICANT SEPTIC NEW 200.00 <br /> KOTHRADE SEWER& WATER STATE SURCHARGE SEPTIC 5.00 <br /> 12059 WHITETAIL AVENUE <br /> HANOVER, MN 55341 MISC FEE 0.00 <br /> O TOTAL 205.00 <br /> Minnesota State License#: 192 MPCA PAID WITH CC# 4122 <br /> OWNER <br /> ERICKSON, VAN &NANCY <br /> 55 GOLDEN VIEW DR <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This permit is tbr only the work described and does <br /> not grant permission for addi[ional 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."I'l�is 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 Yor a period of 180 days at any[ime atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State E3uilding Code.This permit may be <br /> revoked at any time for du cause. <br /> / � /� � �/ � / � <br /> Applicant Permitee �gnature Date Is By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />