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� CITY OF ORONO PERMIT NO.: 2011-00442 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: OS/18/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1155 HERITAGE LA <br /> PIN : 10-117-23-13-0022 <br /> LEGAL DESC : FOXHILL <br /> : LOT 002 BLOCK 003 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SAC ONLY <br /> NOTE: PAID W11�H CONNECTION CHARGE OF$22,400.00 PAID VIA CK#12367 <br /> APPLICANT <br /> S.A.C. 2,230.00 <br /> VILTOFT,JORGEN& LUCILLE TOTAL 2,230.00 <br /> 1 155 HERITAGE LA <br /> WAYZATA, MN 55391- <br /> OWNER <br /> VILTOFT,JORGEN& LUCILLE <br /> 1155 HERITAGE LA <br /> WAYZATA,MN 55391- <br /> AGREEMENT AIVD SWORN STATEMENT <br /> The 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 for only the work described and docs <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 herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of thc date of issuance,or if construction is <br /> suspended for a period of 180 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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />