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� CITY OF ORONO * 2 0 1 5 - 0 P1 7 6 2 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 06/19/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 100 KINTYRE LA <br /> PIN : 32-118-23-43-0020 <br /> LEGAL DESC : KINTYRE TWO <br /> : LOT 3 BLOCK 2 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�STRUCTION TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> ACTIVITY : MOUND SYSTEM - SEPTIC <br /> NOTE: (3)PRECAST CONCRETE 1300 TANKS=MOUND SYSTEM 630 S.F. <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> HAYES& SONS EXC. INC. TOTAL 405.00 <br /> 263 82ND STREET S.E. Payment(s) <br /> MONTROSE, MN 55303- <br /> (763)479-1762 CREDIT CARD 5293 405.00 <br /> Minnesota State License#: sept-L640 <br /> OWNER <br /> Andrade Land Company <br /> 6102 OLSON MEMORIAL HWY <br /> GOLDEN VALLEY, MN 55427- <br /> AGREEMEIVT 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 sepazate <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 the da[e of issuance,or if cons[ruction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring aIl required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � �L�� <br /> (��� �? 1 �� r���s�: l� , l�y, r � � <br /> Applicant Permitee Signature Date Issued By Signature � Date <br />