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' � CITY OF ORONO * 2 0 1 5 - 0 1 3 2 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/02/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 795 LAKEVIEW PKWY <br /> PIN : T000108 <br /> LEGAL DESC : LAKEVIEW OF ORONO <br /> � : LOT 3 BLOCK 2 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW OR REPLACEMENT(SEPTIC SYSTEM) <br /> ACTIVITY : MOLTND SYSTEM-SEPTIC <br /> NOTE: (3)PRECAST CONCRETE TANKS <br /> 1000& 1250 SEPTIC TANKS <br /> 1 - 1250 PUMP TANK <br /> 10 X 63 ROCK BED <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> HAYES& SONS EXC.INC. Payment(s) <br /> 263 82ND STREET S.E. CREDIT CARD 5293 400.00 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#: sept-L640 <br /> OWNER <br /> Source Land Development Inc. <br /> 18215 45TH AVE N <br /> STE D <br /> PLYMOUTH,MN 55446- <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 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 goveming 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 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 /> revoke ime for due ause. <br /> . <br /> Z- �_ l� �� � S� /�i ���S' <br /> � �� <br /> Appl t Permitee Signature Date Issued y ignature Date <br />