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t <br /> ' `" CITY OF ORONO * z 0 1 3 — 0 B 1 z 1 * <br /> 2750 KELLEY PARKWAY �ATE �SSUED: 02/20/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1545 MAPLE PL <br /> PIN : 08-117-23-33-0029 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 007 BLOCK 006 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: D[SCONNECT ONLY <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 /> Maple Place LLC <br /> 550 25TH AVE N <br /> ST. CLOUD, MN 56303- <br /> AGREEMENT AND SWORN STATEMENT <br /> "I�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 does <br /> not grant permission for additional or related work which requires separate <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 ifconstruction 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 the State[3uilding Code.This permit may be <br /> revoked aiany time for use. �f,j <br /> ����� % / . <br /> ,� � -� � ��.-i l�� _.t� �. �� c l Z.--�,.-z u• �'�J� �� .��,, _ �' <br /> A�icant Permitce Signature Date ►ssued By Signature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />