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CITY OF ORONO * 2014 - 00430 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/12/2014 <br /> ORONO,MN 55356- <br /> 952) 249-4600 FAX: 952) 249-4616 <br /> ADDRESS 2490 OLD BEACH RD <br /> PIN : 21-117-23-22-0005 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT 004 BLOCK 000 <br /> PERMIT TYPE SEWER&WATER <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE DISCONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> UNLIMITED,INC. <br /> 19960 ST FRANCIS BLVD STATE SURCHARGE SEWER&WATER 5.00 ANOKA,MN 55303- <br /> Payment(s) TOTAL 105.00 <br /> (763)753-9867 ts) <br /> CHECK 1002 105.00 <br /> OWNER <br /> MCINTEE, SHAWN&JACQUELINE <br /> 2490 OLD BEACH RD <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 conformarlce with the State Building Code.This permit may be <br /> revoked at e f ue cause. >L <br /> Applican'tilenfliteMignature Date Issued By Si a re Date <br />