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/ <br /> . , . ,� � <br /> CITY OF ORONO * 2 0 1 6 - 0 0 8 6 8 <br /> 4 .�, 2750 KELLEY PARKWAY DATE ISSUED: 07/25/201�' <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 ' <br /> ADDRESS : 5 5 KEENE AVE <br /> PIN . 2-117-23-31-0027 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> :, LOT 000 BLOCK O15 <br /> PERMIT TYPE � SEWER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE % : CONNECTION <br /> � <br /> NOTE: NEW SEWER COM�ECTION <br /> / <br /> % <br /> � <br /> % <br /> i' <br /> i' <br /> / <br /> i <br /> � <br /> i <br /> APPLICANT SEWERCONNECT/DISCONNECT/REk�AIR 50.00 <br /> STATE SURCHARGE SEWER&WA R 1.00 <br /> SITE WO S DESIGN TOTAL 51.00 <br /> 1225 HWY 169 N. Payment(s) <br /> PLYMOU H,MN 55441 CHECK 5746 � 51.00 <br /> (763)54 3367 ' <br /> / <br /> � <br /> �� <br /> i OWNER <br /> H& Development Prtnrshp <br /> DE TLOFF,HB&JC � <br /> 10 1 TWELVE OAKS CENTER DR#10 <br /> WAYZATA,MN 55391- ' <br /> � <br /> � <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,appiicable City approvals,and the �' <br /> State Building Code. This permit is for only the work described and dces j <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 /> shali be compied with whether or not specified herein.This permit will <br /> % <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 iod of 180 days at any time after work has commenced. / <br /> The applicant is sponsible for assuring all required inspections are <br /> requested in con rmance with the State Building Code.This permit may be <br /> revoked at any t' e for due cause. ! _ <br /> �� � ��� � � �� <br /> � � <br /> Applicant P itee Sigr►ature Date Issued By ' �lture Date <br />