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�� - � CITY OF ORONO * 2 0 1 2 - 0 0 6 9 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/20/2012 <br /> ORONO,MN 55356- <br /> • (952) 249-4600 FAX: (952)249-4616 <br /> REPRINTED ON 7/20/2012 <br /> ADDRESS : 2771 SHADYWOOD RD <br /> PIN : 21-117-23-24-0059 <br /> LEGAL DESC : REG.LAND SURVEY NO.0358 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE :, ESCROW FEE-APPLICANT <br /> NOTE: THIS$2,000 ESCROW IS TIED TO ZONING PERMIT#2012-00695 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> OGLE,RICHARD&MARLY TOTAL 2,000.00 <br /> 2771 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <br /> OWNER <br /> OGLE,RICHARD&MARLY <br /> 2771 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <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 sepazate <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 pertnit 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 />