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� �� CITY OF ORONO * 2 0 1 5 - 0 1 0 0 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/06/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1432 SHORELINE DR <br /> PIN : 11-117-23-22-0014 <br /> LEGAL DESC : UNPLATTED 11 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMTT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO BUILDING PERMIT-2015-00884 AND LAND USE#15-3745 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> JOHNSON,MATTHEW&SUSANNE TOTAL 2,500.00 <br /> 1432 SHORELINE DR Payment(s) <br /> CHECK 5037 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> JOHNSON,MATTHEW&SUSANNE <br /> 1432 SHORELINE DR <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pertnit is for only the work described and dces <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 I80 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 />