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CITY OF ORONO PERMIT NO.: 2010.00759 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuED: 08/24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> REPRINTED ON 8/24/2010 <br /> ADDRESS : 1860 SHADYWOOD RD <br /> PIN : 17-117-23-24-0018 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS ESCROW PAYMENT OF$2500.00 IS TIED TO ZONING PERMIT 2010-00758 PAID BY RHONDA OMLIE FOR RETAINING <br /> WALL AND MINOR LAND ALTERATION -CHECK#5869 <br /> � <br /> APPLICANT <br /> OMLIE, WILLIAM&RHONDA ESCROW FEE-APPLICANT 2,500.00 <br /> 1860 SHADYWOOD RD TOTAL 2,500.00 <br /> WAYZATA, MN 55391 <br /> OWNER <br /> OMLIE, WILLIAM&RHONDA <br /> 1860 SHADYWOOD RD <br /> WAYZATA,MN 55391 <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 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 aze <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 S�gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />