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� � � CITY OF ORONO <br /> * 2 0 1 5 - 0 0 8 9 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/22/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3375 GRAHAM HILL RD <br /> P[N : OS-117-23-11-0018 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 2ND ADDITION <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> ACTIVITY : MOLJND SYSTEM - SEPTIC <br /> NOTG: (3)PRECAST CONCRETE TANK 1250 GALLON <br /> MOLTND-50'X 99'ROCK BED 10 X 62.5' <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> KLINGBERG EXCAVATING Payment(s) <br /> P O BOX 6 CHECK 17574 400.00 <br /> PRIOR LAKE,MN 55372- <br /> (952)447-2557 <br /> Minnesota State License#: sept-L49 <br /> OWNER <br /> Wooddale Builders <br /> 6117 BLUE CIRCLE DR, STE 101 <br /> MINNETONKA, MN 55343- <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 /> no[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 whe[her or not specified herein.This permi[will <br /> expire and become null and void if cons[ruction au[horized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> s�spended t'or 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 /> ��t�-�C� 7 � ��/5 <br /> Applicant Permitee Signature Date Iss ed Signature Date <br />