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� ' CITY OF ORONO * 2 0 1 2 - 0 0 7 3 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/06/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3340 GRAHAM HILL RD <br /> PIN : OS-117-23-11-0012 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 2 <br /> : LOT 4 BLOCK 2 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM- SEPTIC <br /> NO"I�G: (3)PRECAST CONCRETE TANKS-SIZE OF`I'ANKS 1250, 1000, 1250 <br /> MOUND"CREATMENT SYSTEM-630 SQUARE FEET <br /> APPLICAIYT SEPTIC NEW 200.00 <br /> PATNODE& SONS STATE SURCHARGE SEPTIC 5.00 <br /> 23200 109TH AVE TOTAL 205.00 <br /> ROGERS, MN 55374 <br /> (763)428-7393 PAID WITH CC# 5026 <br /> Minnesota State License#: 95 <br /> OWNER <br /> MCCARTY, LEROY& LISA <br /> 3340 GRAHAM HILL ROAD <br /> LONG LAKE, MN 55356- <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. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified hcrein.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 atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the S is permit may be <br /> revoked at an ue cause. <br /> � / / / i <br /> Appli nt Permitee Signature Date Issued E3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />