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CITY OF ORONO Ii II I <br /> I '� II <br /> 2750 KELLEY PARKWAY * 2 0 1 2 - 0 1 1 4 9 <br /> DATE ISSUED: 11/09/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 20 ORONO ORCHARD RD N <br /> PIN 35-118-23-33-0009 <br /> LEGAL DESC : ORONO OAKS <br /> LOT 013 BLOCK 001 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE :: RESIDENTIAL <br /> CONSTRUCTION TYPE CONNECTION <br /> NOTE: SAC PAID ON PERMIT 2012-01148 <br /> APPLIANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> Old Orchard Farm,LLC <br /> 30 ORONO ORCHARD RD j STATE SURCHARGE SEWER&WATER 5.00 <br /> WAYZATA,MN 55391- TOTAL 55.00 <br /> OWNER <br /> Old Orchard Farm,LLC <br /> 30 ORONO ORCHARD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND S ORN STATEMENT <br /> The work for which this permit is issu+d shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is fo only the work described and does <br /> not grant permission for additional or lated work which requires separate <br /> permits. All provisions of laws and or••inances governing this type of work <br /> shall be compied with whether or not s.ecifred herein.This permit will <br /> expire and become null and void if co .traction authorized is not <br /> commenced ithin 180 days of the dat' of issuance,or if construction is <br /> suspended r a period of 180 days at: y time after work has commenced. <br /> The applif ant is responsibl or:..surf g all .uired inspections are <br /> requeste in conformance •ith Sta e B •.ng Code.This permit may be <br /> r oke at any ' e ford , c <br /> , + ti /7•110 At sn <br /> Applrr'c..t Permitee Signature `, Date :`� <br /> Issue. .y L ature r # Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB ft E. <br />