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CITY OF ORONO * 2 0 1 7 — 0 0 S e z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/3U2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 765 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0090 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 3 BLOCK 1 <br /> PERMIT TYPE : SEWER&WATER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: SEWER AND WATER CONNECTION <br /> APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 <br /> WATERCONNECT/DISCONNECT/REPAIR 50.00 <br /> BOLLIG& SONS, INC. STATE SURCHARGE SEWER&WATER 1.00 <br /> 11401 COLTNTY ROAD 3 <br /> HOPKINS,MN 55343- S.A.C. 0.00 <br /> (952)938-4133 TOTAL 101.00 <br /> Payment(s) <br /> CREDIT CARD 9081 101.00 <br /> OW1vER <br /> Wooddale Builders Inc <br /> 6117 BLUE CIRCLE DR <br /> LJN[T#101 <br /> MINNETONKA,MN 55343- <br /> AGREEMENT AND SWORN STATEMENT <br /> The 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 onty 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 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 are <br /> requested in formance with the State Buildi Code.This permit may be <br /> revoked a time for due use. <br /> �- � I • I � ,�/ ,l� <br /> Applicant Permitee Signature Date Issued B ignature Date <br />