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CITY OF ORONO II 11111111 II II 1111 1111 II <br /> * 2 0 1 4 - 0 0 5 7 5 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/24/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 35 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-31-0004 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> OT 023 BLOCK 000 <br /> PERMIT TYPE EPTIC <br /> PROPERTY TYPE ESIDENTIAL <br /> 410 <br /> CONSTRUCTION TYPE EW <br /> ACTIVITY OUND SYSTEM-SEPTIC <br /> APPLICANT SEPTIC NEW 200.00 <br /> STATE SURCHARGE SEPTIC 5.00 <br /> ELMER J.PETERSON COMPANY TOTAL 205.00 <br /> 5921 DAGUE AVE SE <br /> Payment(s) <br /> DELANO,MN 55328 <br /> (763)972-2420 CREDIT CARD 6257 205.00 <br /> Minnesota State License#: BUIL-219 <br /> OWNER <br /> GUERINGER ET AL,JOHN R <br /> 535 OLD CRYSTAL BAY RD S <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SW RN STATEMENT <br /> The work for which this permit is issued s all be performed according to <br /> the approved plans and specifications,app icable City approvals,and the <br /> State Building Code. This permit is for y the work described and does <br /> not grant permission for additional or rela d work which requires separate <br /> permits. All provisions of laws and ordin ces governing this type of work <br /> shall be compied with whether or not spec fied herein.This permit will <br /> expire and become null and void if const tion authorized is not <br /> commenced within 180 days of the date o issuance,or if construction is <br /> suspended for a period of 180 days at any ime after work has commenced. <br /> The applicant is responsible for assuring a I required inspections are <br /> requested in conformance with the State B ilding Code.This permit may be <br /> revoked at any time for due cause. <br /> Oft,/7,,, aixa... --_-__ <br /> A i ermitee Signature Date Issued/By Signature Date <br /> I <br />