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CITY OF ORONO * z p� 1 3 - 0 0 1 B 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/2U2013 <br /> ORONO,MN 55356- <br /> (952 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1535 MINNIE AVE <br /> PIN : 08-117-23-33-0065 <br /> LEGAL DESC : HICKORY HILL <br /> : LOT 005 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: SEWER DISCONNECT <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WESTONKA SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 <br /> 6501 CO.RD 15 <br /> MOUND,MN 55364 TOTAL 55.00 <br /> (952)472-4959 PAID WITH CC# 7464 <br /> Minnesota State License#: 1804 <br /> OWNER <br /> LLC,LANDSOURCE <br /> 550 25TH AVE N <br /> ST CLOUD,MN 56303- <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 constsuction 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 wi e te Building Code.This permit may be <br /> revoked at an�' for due a <br /> .-� � � ��( � ( �� 2/� <br /> Ap 'cant Permitee ignature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />