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CITY OF ORONO I I I 11 I I I I' 11111 0 11111 <br /> * z0 18 - 00026 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/09/2018 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3286 NAVARRE LA <br /> PIN : 17-117-23-44-0109 <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B <br /> : LOT 000 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 /> STATE SURCHARGE SEWER&WATER 1.00 <br /> CHUCK'S EXCAVATING TOTAL 51.00 <br /> 760 WEST 96TH STREET Payment(s) <br /> CHANHASSEN,MN 55317- CHECK 6228 51.00 <br /> (952)496-2874 <br /> Minnesota State License#: SW-L3320 <br /> OWNER <br /> ASHDOWN,GRACE MARIE&GLEN <br /> 3286 NAVARRE LA <br /> WAYZATA,MN 55391- <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 governing 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Pee"&c7-- <br /> Applicant Permitee Signature Date Issue By Signature Date <br />