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CITY OF ORONO PERMIT NO.: 2009-00174 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- �ATE IssuEv: 04/23/2009 <br /> ' 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3225 GRAHAM HILL RD <br /> PIN : OS-117-23-14-0067 <br /> LEGAL DESC : GRAHAM H[LL PRESERVE <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ��k�`� I G � '� �.( � i' ��i``\� {�c�`� <br /> APPLICANT <br /> SEPTIC NEW 200.00 <br /> GROTH SEWER&WATER STATE SURCHARGE SEPTIC 0.50 <br /> 775 TOWER DRIVE TOTAL 200.50 <br /> HAMEL, MN 55340- <br /> (763)478-6712 <br /> Minnesota State License#: 058606-PM <br /> OWNER <br /> WEBER, AARON <br /> 3225 GRAHAM HILL RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permi[is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Codc. This perniit is ior only the work described and does <br /> not grant permission for additional or related work which requires separatc <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced wi[hin 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any timc alter 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 /> �J �i'_'l��-�_ � � �_�f i i (,�_)� ,� ��-�-- � �,�L�j`� `t /� � �C��j <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />