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CITY OF ORONO � <br /> � � 2750 KELLEY PARKWAY * 2 0 1 6 - 0 0 4 6 7 * <br /> DATE ISSUED: OS/02/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS � : 1890 SHADYWOOD RD � <br /> PIN : 17-117-23-24-0019 <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: ESCROW FOR ZONING PERMIT#2016-00427-PD BY:ANGELA LUNDBERG-CK#5323-$2,000.00 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> TOTAL 2,000.00 <br /> LUNDBERG,MIKE&ANGELA Payment(s) <br /> 1890 SHADYWOOD RD CHECK 5323 2,000.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> LUNDBERG,MIKE&ANGELA <br /> 1890 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 specifica[ions,applicable Ciry approvals,and the <br /> State Building Code. 1'his pertnit 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 ail required inspections are `�L.I-' <br /> requested in wnformance with the State Building Code.This permit may be � <br /> revoked at any time for due cause. <br /> �Q �. 5 —Z—I� � �..—�e�L <br /> Applicant Permitee Si ature Date Issued By Signature Date <br />