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� CITY OF ORONO PERMIT NO.: 2010-00558 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/07/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4740 NORTH ARM DR W <br /> PIN : 06-117-23-23-0009 <br /> LEGAL DESC : LJNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> APPLICANT SEPTIC REPAIR 100.00 <br /> MARTYS EXCAVATING STATE SURCHARGE SEPTIC 5.00 �/ <br /> 7185 RUTZ LAKE ROAD <br /> MAYER,MN 55360 TOTAL 105.00 <br /> (952)657-2548 <br /> Minnesota State License#: 768 <br /> OWNER <br /> HEDBERG,JOHN&JANICE <br /> 4740 NORTH ARM DR W <br /> MOUND,MN 55364 <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 rype of work <br /> shall be compied with whether or not speci£ed 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 /> c�� c <br /> .�F�J7�.t/..,�2 Z,.�=s.�. �-�— �/ 7 / ,us IO l l <br /> plicant Permitee Signature Date Issued By i ature e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />