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� � CITY OF ORONO PERMIT NO.: 2oos-oo�24 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssuEn: 08/12/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 205 HOLLANDER RD <br /> PIN : 25-118-23-44-0011 <br /> LEGAL DESC : HOLLY ACRES 2ND ADDN <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : NEW <br /> APPLICANT SEPTIC NEW 100.00 <br /> JD EXCAVATING INC. STATE SURCHARGE SEPTIC 0.50 <br /> PO BOX 48687 TOTAL 100.50 <br /> COON RAPIDS,MN 55433- <br /> Minnesota State License#:L2271 <br /> OWNER <br /> BURNS,DAVID&CASSIDY <br /> 205 HOLLANDER RD <br /> WAYZATA,MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he 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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 aze <br /> requested in conformance with the State Building Code.This perrr►it may be <br /> revo a any time due cause. <br /> �� 2O �O� �'/ �� / `�� <br /> Ap icant Permitee Sign Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />