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CITY OF ORONO IIII_ ! �� I'I II <br /> * <br /> 2750 KELLEY PARKWAY * 2 1 0 0 1 5 9 <br /> DATE ISSUED: 03/08/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 665 ORCHARD PARK RD <br /> PIN : 31-118-23-11-0005 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> ACTIVITY : MOUND SYSTEM-SEPTIC <br /> NOTE: 3 PRECAST CONCRETE TANKS <br /> 630 SF MOUND SYSTEM <br /> APPLICANT SEPTIC NEW 200.00 <br /> KOTHRADE SEWER&WATER STATE SURCHARGE SEPTIC 5.00 <br /> 12059 WHITETAIL AVENUE <br /> HANOVER,MN 55341 TOTAL 205.00 <br /> 0 PAID WITH CC# 4122 <br /> Minnesota State License#:492 MPCA <br /> OWNER <br /> REYNOLDS, WILLIAM&MOLLIE <br /> 3630 LIVINGSTON AVE <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 caul <br /> Applicant Permitee Signature Datef F <br /> Issu 4lBy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />