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CITYOFORONO * 2015 - 00330 * <br /> Y 2750 KELLEY PARKWAY DATE ISSUED: 03/20/2015 <br /> � ORONO, MN 55356- <br /> 952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3484 LYRIC AVE <br /> PIN : 17-117-23-43-0157 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT MB BLOCK 5 <br /> PERMIT TYPE : SEWER& WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�TSTRUCTION TYPE : CONNECTION <br /> NOTE: SAC PD ON PERMIT#2014-01002 10/30/14 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> TUMA CONSTRUCTION STATE SURCHARGE SEWER& WATER 5.00 <br /> 5045 COUNTY ROAD 19 <br /> MINNETRISTA, MN 55359- TOTAL 105.00 <br /> (763)479-2982 Payment(s) <br /> CHECK 4634 105.00 <br /> OWNER <br /> Energy Star Homes of MN <br /> 25 MOUND AVE <br /> TONKA BAY,MN 55331- <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 separate <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 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 respons�ble for assurin II required inspections aze <br /> requested,i�i'conform �e wi t e S e Buil� ding'COde.This permit may be <br /> revoked 3f any time qf due cause. <br /> Z.0 ��� r' .. <br /> �. �� �� �����..��_v�V�.C�.G� �� �"Z� � � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />