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CITY OF ORONO PERMIT NO.: 2011-00401 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/15/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 2985 WATERTOWN RD <br /> PIN 04-117-23-21-0001 <br /> LEGAL DESC AUDITOR'S SUBD.NO.230 <br /> LOT 006 BLOCK 000 City of Orono <br /> PERMIT TYPE : SEPTIC 2750 Kelley Parkway <br /> Orow MN `i5356 '152-249-�46 0 <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE NEW <br /> Receipt pt !4o: 3,004648 May 31. 401; <br /> Burns Excavating <br /> NOTE: (3)PRECAST CONCRETE TANKS-SIZE OF TANKS 1250, 1250, 1000 <br /> MOUND SYSTEM-630 SQ.FT. Permits <br /> ?Ot7.I-00401 2935 Watertow 200.00 <br /> n ltd <br /> 101-3c 30 <br /> Mec:hancal!Sent ic;Other <br /> Permits <br /> 2011-00401 Z'385 Watertoa 5,00 <br /> n Rn <br /> 101-20WI2 <br /> Due to go'dts-Stdte <br /> Total. <br /> Check <br /> Check No: 21182 2^05.00 <br /> Payor: <br /> Burns Excavating <br /> Total Applied: 205.00 <br /> .00 <br /> APPLICANT SEPTIC NEW 200.00 <br /> BURNS EXCAVATING STATE SURCHARGE SEPTIC 5.00 <br /> 2615 CO. RD.21 TOTAL 205.00 <br /> WATERTOWN,MN 55388 <br /> OWNER <br /> GHERARDI,LORI <br /> 1010 WILLOW VIEW LANE <br /> LONG LAKE,MN 55356- <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 use. <br /> Applicant Permitee Sigriature DateC <br /> I Issuetoy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />