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• � � CITY OF ORONO PERMIT NO.: 2010-01197 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/20/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1669 NORTH FARM RD <br /> PIN : 27-118-23-44-0008 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: NEW SEWER CONNECTION <br /> SAC PAID 1 U14/79 WHEN HOUSE WAS BUILT. <br /> ASSESSMENT OF$7500.00 PAID ON 10/2U2010 <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> GROTH SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 <br /> 775 TOWER DRIVE TOTAL 55.00 <br /> HAMEL,MN 55340- <br /> (763)478-6712 <br /> Minnesota State License#: 058606-PM <br /> OWNER <br /> BEENDERS&PETER MONTGOMERIE,ANTOINETTE <br /> 1669 NORTH FARM RD <br /> LONG LAKE, MN 55356- <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 rype 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 are <br /> requested in conform �rth the State Building Code.This permit may be <br /> revoked at a t� for�dUe cause. ---------...._.,. <br /> \ ,. �. y <br /> .. � � 2� /2 /2!� / d <br /> A plicant P rmit e ' n tftre Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />