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r <br /> CITY OF ORONO * z a 1 4 — 8 8 9 1 3 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/19/2014 <br /> ORONO, MN 55356- <br /> 952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS 3700 NORTHERN AVE <br /> PIN 17-117-23-34-0002 <br /> LEGAL DESC REG.LAND SURVEY NO.0763 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE SEWER&WATER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 5.00 <br /> J P SCHMITZ CONSTRUCTION COMPANY LL WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 16450 117TH AVE N TOTAL 105.00 <br /> MAPLE GROVE,MN 55369- <br /> Payment(s) <br /> CHECK 11650 55.00 <br /> CHECK 11650 50.00 <br /> 0\V\EIZ <br /> Real Assets II,LLC <br /> 550 25TH AVE N <br /> ST CLOUD, MN 56303- <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 confor a ith the State Building Code.This permit may be <br /> revoked at� a for d cau <br /> -'4- / l <br /> icant Permitee Signature ate <br /> g Issue y Signature Date <br />