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CITY OF ORONO PERMIT NO.: 2011-00348 <br /> 2750 KELLEY PARKWAY <br /> e <br /> ' ORONO, MN 55356- DATE ISSUED: 06/02/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 155 KINTYRE LA <br /> PIN : 32-118-23-43-0016 <br /> LEGAL DESC : KINTYRE TWO <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : SEPT[C <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM- SEPTIC <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 5.00 <br /> 263 82ND STREET S.E. <br /> MONTROSE, MN 55303- MISC FEE 0.00 <br /> (763)479-1762 TOTAL 205.00 <br /> Minnesota State License#: 640 PAID WITH CC# 5293 <br /> OWNER <br /> ROLL&JACQUELINE W[LLIAMS-ROLL, MICHAEL <br /> 75 FERNDALE RD N <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIVD SWORN STATEMENT <br /> The work for which Ihis permit is issucd shall be pertormed 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 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 consuuction 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[3uilding Code.This permit may be <br /> �r�an ime for due cause. <br /> _ - -. � � Z � // <br /> i i <br />',_.ApPlicant F'erm' ee Signature Date Issued By Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />{ <br />