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y r 7 <br /> ' CITY OF ORONO * 2 0 1 6 - 0 0 5 6 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/26/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 515 KOKESH FARM RD <br /> pIN : 31-118-23-14-0009 <br /> LEGAL DESC : KOKESH FARMS <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(MOLJND) <br /> NOTE: (3)PRECAST CONCRETE TANKS-2-1500 AND 1 -1300 <br /> MOUND TREATMENT SYSTEM <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> KOTHRADE SEWER&WATER Payment(s) <br /> 12059 WHITETAIL AVENUE CREDIT CARD 4122 400.00 <br /> HANOVER,MN 55341 <br /> Minnesota State License#:SW-192 MPCA <br /> OWNER <br /> LITECKY,MARK&ANITA <br /> 515 KOKESH FARM RD <br /> MAPLE PLAIN,MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he 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 dces <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 whett►er 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 /> � � , �v l� 7 i Z�i /� <br /> Applicant Permitee Signature Date Issued B gnature Date <br />