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' ' CITY OF ORONO * z 0 Ili 6 I 0 i 468 * <br /> � <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/25/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 500 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-42-0029 <br /> LEGAL DESC : CRYSTAL BAY RETREAT <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(MOUND) <br /> NOTE: MOUND SYSTEM <br /> 3 PRECAST CONCRETE TANKS <br /> 1300, 1000, 1300 <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> TOTAL 400.00 <br /> HAYES&SONS EXC. INC. Payment(s) <br /> 263 82ND STREET S.E. CREDIT CARD 5293 400.00 <br /> MONTROSE,MN 55303- <br /> (763)479-1762 <br /> Minnesota State License#:sept-L640 <br /> OWNER <br /> MERZ,BRIAN&KATIE <br /> 2412 BLACK LAKE RD <br /> SPRING PARK,MN 55384- <br /> AGREEMENT AND SWORN STAT 0MENT <br /> The work for which this permit is issued shall be perform:. according to <br /> the approved plans and specifications,applicable City app ovals,and the <br /> State Building Code. This permit is for only the work des.ribed and does <br /> not grant permission for additio al or related work which quires separate <br /> permits. All provisions of laws .rid ordinances governing his type of work <br /> shall be compied with whether dr not specified herein.Thi.permit will <br /> expire and become null and void if construction authoriz • is not <br /> commenced within 180 days of the date of issuance,or if•onstruction is <br /> suspended for a period of 180 days at any time after work as commenced. <br /> The applicant is responsible for assuring all required inspe tions are <br /> requested in con ance with the State Building Code.T is permit may be <br /> revoke n Mme for due opus . <br /> 4.-7L(/ 7it i ��5i/7 <br /> App 'cant Permitee S' t D. a Issued :. Signature Date <br />