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CITY OF ORONO PERMIT NO.: 2011-01147 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 10/10/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 360 NORTH ARM LA <br /> PIN : 06-117-23-24-0012 <br /> LEGAL DESC : NORTH ARM ESTATES 4TH ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> NOTE: SOILS NEED TO BE VERIFIED BEFORE INSTALLATION OF THE MOUND. <br /> APPLICANT SEPTIC NEW 200.00 <br /> MARTYS EXCAVATING STATE SURCHARGE SEPTIC 5.00 <br /> 7185 RUTZ LAKE ROAD TOTAL 205.00 <br /> MAYER,MN 55360 <br /> (952)657-2548 <br /> Minnesota State License#: 768 <br /> OWNER <br /> Rohan Lund, Inc. <br /> 360 NORTH ARM LA <br /> MOLJND,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 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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time fordue cause. <br /> `�'�V��G� l l <br /> � � <br /> Applicant Permitee Signature Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A OVE. <br />