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CITY OF ORONO PERMIT NO.: 2009-00813 <br /> ' � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �ssuEu: 1U19/2009 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2195 FRENCH LAKE RD <br /> PIN : 10-117-23-21-0006 <br /> LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> , , . � , �,�. `,'�=_� '�:, <br /> , , ` <br /> NOTE: PRECAS"C CONCRETE TANKS-3 TANKS-SIZE OF EACH- 1,000 <br /> MOUND SYSTEM-630 S.F. <br /> APPLICANT SEPTIC NEW 200.00 <br /> HAYES& SONS EXC. INC. STATE SURCHARGE SEPTIC 0.50 <br /> 263 82ND STREET S.E. <br /> MONTROSE, MN 5530:r TOTAL 200.50 <br /> (763)479-1762 PAID WITH CC# 9999 <br /> Minnesota State License#: 640 <br /> OWNER <br /> MILLER, GARY& SYLVIA <br /> 2195 FRENCH LAKE RD <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Yor 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 no[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 /> suspcnded for a period of 180 days a[any time af[er work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the Sta[e Building Code.This permit may be <br /> revo d at an 'me for due cause. <br /> ��' �� ' � � � <br /> Applicant Permitee ignature Date Issued By Si ature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />