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- CITY OF ORONO PERMIT NO.: 2010-01189 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/14/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 550 ORONO ORCHARD RD S <br /> PIN : 02-117-23-31-0006 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK 013 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> NOTE: SEWER REPAIR <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> ELMER J. PETERSON COMPANY STATE SURCHARGE SEWER&WATER 5.00 <br /> 5921 DAGUE AVE SE TOTAL 55.00 <br /> DELANO,MN 55328 <br /> OWNER <br /> LARSON, SANDRA S <br /> PO BOX 546 <br /> WAYZATA,MN 5539 1- <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 /> r ed at any tim for due cause. / <br /> �2,/14i i j° <br /> i v ' /? /v <br /> Applicant rmitee Signature Date Issue•/I:y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />