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� ' ' � CITY OF ORONO * Z 0 1 3 — 0 0 9 4 3 * 2750 KELLEY PARKWAY pATE �ss[1E�: 10/09/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 120 GOLDEN VIEW DR PIN : 33-118-23-43-0024 LECAL DESC : HALLSON ESTATES 2ND ADDN : LOT 003 BLOCK 001 PERMIT TYPE : SEPTIC PROPERTY TYPE : RESIDENTIAL CONSTRUCT[ON TYPE : NEW ACTIVITY : MOUND SYSTEM - SEPTIC NO�I'I:: [k� EXISTING 2-]000 GAL.THANKS ARE REUSb'D,1�HEN ADD. 500 GALI_ON"T�ANK[S NOT NECESSARY. 1000 GAL LIF7�TANK [S REQIJIRED APPLICANT SF.PTIC NEW 200.00 NORDBERG EXCAVATING STATE SURCHARGE SEPTIC 5.00 23658 700TH AVE DASSEL, MN 55325- TOTAL 205.00 (320)275-3045 Minnesota State License#: C2176/L112 OWNER HALLSON,JOHN PO BOX 171 LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this pennit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separatc permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspcctions are requested in conformance with the State Building Code."I'his permit may be re oked at any tim for due cause. � �� _ ' � �� G �i o� iot o� � �� /l�� . Ap icant Permrtee Signaturc Date �-� � [ssu d By S naturc Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.