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*� CITY OF ORONO PERMIT NO.: 2011-00416 <br /> �� ° � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 06/06/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1255 DICKENSON ST <br /> PIN : 02-117-23-31-0027 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK O15 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> BOLLIG& SONS, INC. STATE SURCHARGE SEWER& WATER 5.00 <br /> 11401 COUNTY ROAD 3 TOTAL 55.00 <br />� HOPKINS,MN <br /> (612)938-4433 <br /> OWNER <br /> DETTLOFF, MARION <br /> 1255 DICKENSON ST <br /> WAYZATA, MN 55391 <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 E3uilding 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 herein.This permit will <br /> expire and becomc 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 as uri all requjred inspections are <br /> �requested in conformance with� ate �t�g Code.This permit may be <br />, revoked at any time f �a <br /> .,-:.lL �l v l �/ l l <br /> pp icant Permitee Signature Date Issued y Sig ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED AB E. <br />