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� -- CITY OF ORONO * 2 0 1 3 — 0 0 6 6 � <br /> 2750 KELLEY PARKWAY pATE ISSUEn: 07/17/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1645 SHADYWOOD RD <br /> PIN : 17-117-23-22-0013 <br /> LEGAL DESC : LINPLATTED 17 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING APPLICATION 13-3622-PD CHECK#001013 BY LANDSOURCE <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> LANDSOURCE ESCROW FEE-DEVELOPER 0.00 <br /> 3925 CHERRY AVE <br /> MOUND, MN 55364- TOTAL 2,500.00 <br /> OWNER <br /> LANDSOURCE <br /> 3925 CHERRY AVE <br /> MOUND, MN 55364- <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 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 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />