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. <br /> r ' CITY OF ORONO * 2 0 1 4 - 0 1 1 4 P1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/06/2014 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 709 SANDSTONE CIR <br /> PIN : 33-I18-23-11-0044 <br /> LEGAL DESC : STONEBAY <br /> : LOT 041 BLOCK OOl <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: WATER&SEWER CONNECTION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 <br /> T&J CONCRETE WATER CONNECT/DISCONNECT/REPAIR 50.00 <br /> 9100 BALTIMORE STREET NE STATE SURCHARGE SEWER&WATER 5.00 <br /> BLAINE,MN 55449- TOTAL 105.00 <br /> (763)413-0988 Payment(s) <br /> Minnesota State License#: SW-646112,GENR-PB646112 CHECK 14233 105.00 <br /> OWNER <br /> Stonebay Builders LLC <br /> 14870 BROCKTON LN <br /> DAYTON, MN 55327- <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 goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> 1� <br /> � ���1 � � '-v` �� i � if�/ <br /> A licant Permitee Si nature Date T— <br /> PP b Issu d By Signature Date <br />