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CITY OF ORONO PERMIT NO.: 2010-00645 <br /> � 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- DATE IssuEv: 08/04/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1978 SHADYWOOD RD <br /> PIN : 17-117-23-24-0026 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> NOTE: $2,000 SB COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2000.00 <br /> HOW DID THEY PAY? CHECK 7215&WHO PAID?HOMEOWNER <br /> ESCROW PERMIT#: 2010-00644 <br /> ESCROW FEE FOR: EROS[ON CONTROL&ENGINEERING REVIEW COSTS <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> PETERS,BRIAN ENGINEERING REVIEW COSTS <br /> 1978 SHADYWOOD ROAD <br /> WAYZATA,MN 55391- TOTAL 50.00 <br /> PAID WITH CASH 50.00 <br /> OWNER <br /> PETERS, BRIAN <br /> 1978 SHADYWOOD ROAD <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 bewme 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 requiced inspections aze <br /> cequested in conf ce with the State Building Code.This permit may be <br /> revokad at a ti r due cause. <br /> ',. � ,� � / / �� / / <br /> Applicant ermitee Signature Date Issue y ' na ure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED A VE. <br />