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CITY OF ORONO * Z 0 1 6 - 0 0 9 3 3 * <br /> - 2750 KELLEY PARKWAY DATE ISSUED: 08/08/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1700 BOHNS POINT RD <br /> PIN : 16-117-23-22-0003 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.349 <br /> : LOT 003 BLOCK 000 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DISCONNECTION <br /> NOTE: DISCONNECT ONLY <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> STATE SURCHARGE SEWER&WATER 1.00 <br /> GROTH SEWER& WATER TOTAL 51.00 <br /> 775 TOWER DRIVE <br /> HAMEL, MN 55340- Payment(s) <br /> (612)919-0247 CHECK 8941 51.00 <br /> O W 1vER <br /> SANTRACH&MELISSA KREIMER-SANTRACH, PETER <br /> 1700 BOHNS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEME1vT <br /> The��ork for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 da[e of issuance,or if construction is <br /> suspended for a period of I 80 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 /> revo�e�. t any time for due cause. � <br /> C � ,� � _ - �'' � � <br /> � ��-t6 ��, �, � � f'���� �: - � � -�' � 1 �� <br /> Appl t ermitee Signature Date Issued By Si ture Date <br />