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CITY OF R N PERMIT <br /> O O O Permit Number: <br /> 2750 KP,F,�ey Parkway - PO Box 66 P07965 <br /> Crystal�Bay, Minnesota 55323 Permit Type: Sewer and Water Permit <br /> (952) 249-4600 Date Issued: 9�2o�2ooa <br /> SITE ADDRESS: 791 Boulder Dr <br /> Long Lake,MN 55356 <br /> PID: 33-118-23-11-0012 <br /> DESCRIPTION: <br /> Proposed Use: <br /> Permit Class: General <br /> Permit Sub-type(s): Sewer&Water Connections <br /> Pernut Type: Sewer and Water Pernut <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: <br /> NOTICES/REMARKS: <br /> SAC Paid 9/10/04-P07895 <br /> FEE SUMMARY: Permit Fee: $ 70.00 Valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> TOTAL FEE: $ 70.50 <br /> APPLICANT: �'estonka Water&Sewer OWNER: John Terrance Homes, LLC <br /> 6501 County Rd 15 8266 Xene Lane <br /> Mound,MN 55364 Maple Grove,MN 55311 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> � ��� � <br /> APPLICANT PERMITEE SIGNATURE 1 SUED BY SIGNATURE <br /> Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 <br />