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� � CITY OF ORONO * Z p� 1 3 - 0 0 7 B 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/13/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTED ON 8/13/2013 <br /> ADDRESS : 3625 JACOBS MILL RD <br /> PIN : 32-118-23-24-0013 <br /> LEGAL DESC : JACOBS MILL <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> NOTE: (2)PRECAST CONCRETE TANKS <br /> 2000 COMBO AND 1000 PUMP <br /> MOUND TREATMENT SYSTEM-500 S.F. <br /> SOILS TO BE VERIFIED AT TANK INSPECTION <br /> APPLICANT SEPTIC NEW 200.00 <br /> MARTYS EXCAVATING STATE SURCHARGE SEPTIC 5.00 <br /> 7185 RUTZ LAKE ROAD <br /> MAYER, MN 55360 TOTAL 205.00 <br /> (952)657-2548 <br /> Minnesota State License#: 768 <br /> OWNER <br /> SCHMID, KURT&CAROL <br /> 2950ISLAND VIEW DRIVE <br /> MOLJND,MN 55364- <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 rype 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 the 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 /> � �J �l �� l�3 �i /�r / <br /> Applicant Permitee Signature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />