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CITY OF ORONO PERMIT <br /> 2750 Kelley Parkway - PO Box 66 Permit Number: Poass4 <br /> Crystal Bay, iVlinnesota 55323 Permit Type: Sewer and Water Permit <br /> (952) 24`-4600 Date Issued: �ti2i2ooi <br /> SITE ADDRESS: 15 Brown Rd S <br /> I.ong Lake,MN 55356 <br /> PID: 34-118-23-34-0010 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Permit Class: General <br /> Permit Type: Sewer and Water Permit Permit Sub-type(s): Sewer Connection <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> SAC Fee: $ 1,150.00 <br /> TOTAL FEE: $ 1,185.50 <br /> APPLICANT: Sullivan's Utility Services, Inc. OWNER: John& Bonnie Eiss <br /> 3660 Hwy 101 S 15 Brown Rd S <br /> Wayzata, MN 55391 Long Lake MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEIv1ENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> ,, <br /> (T���..� <br /> � /�� �'~ ��� <br /> APPLICANT P ITEE SIGNATURE ISSUEDBY SIGNATURE <br /> Conies: 1-File(SiQnitures Reauired), 1-Anolicant. 1-Monthlv Reoorts, 1-Assessine. 1-Finance Page 1 <br />