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' '' " ` ` CITY OF ORONO � <br /> 2750 KELLEY PARKWAY * 2 0 1 Z — 0 fd 9 Pl 2 * <br /> DATE ISSUED: 09/1]/2012 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX; 952 249-4616 <br /> ADDRESS : 1910 SHORELINE DR <br /> PIN : 10-117-23-42-0017 <br /> LEGAL DESC : REG.LAND SURVEY NO.0096 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-WETLAND <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-WETLAND <br /> NOTE: WETLAND BUFFER ESTABLISHMENT ESCROW AGREEMENT <br /> PERMIT 2012-00828 <br /> APPLICANT <br /> &H MOUSAVINASAB,MA7ID FEHRESTI ESCROW FEE-WETLAND 2,000.00 <br /> 1910 SHORELINE DR TOTAL 2,000.00 <br /> WAYZATA,MN 55391- <br /> Cit of Orono <br /> Orono�N�ey�y <br /> 952-249-�600 <br /> OWNER �ceipt No; 3.007595 <br /> &H MOUSAVINASAB,MAJID FEHRESTI �p 1I� c�Q12 <br /> 1910 SHORELINE DR Majid Fehresti <br /> WAYZATA,MN 55391- <br /> Pla�i�ng�a�nd I�i� � <br /> �O1P-o090E 1910 Shoa+eline P,000.40 ' <br /> Dr' - i�etland EscroM <br /> AGREEMENT AND SWORN STATEMENT 301,� <br /> The work for which this permit is issued shall be performed according to �f� ��'�vPloper Deposit <br /> the approved plans and specifications,applicable City approvals,and the TO#al: ; <br /> State Building Code. This pemiit is for only the work described and does 2!000.00 <br /> not gant pem�ission for additional or related work which requ'ues separate Q�k <br /> pemiits. All provisions of laws and ordinances goveming this type of work �iECk 1�0: 24� � <br /> shall be compied with whether or not specified herein.This permit will p,��; �!�0•00 j <br /> expire and become null and void if construcdon suthorized is not id F�rest i <br /> commenced within 180 days of the date of issuance,or if construction is TOti� {�1lEdC ����� � <br /> suspended for a period of 180 days at any time after work has comroenced, ' <br /> The applicant is responsible for assuring all required inspections are Chd1�� j��� � � <br /> requested in conformance with the State Building Code.This permit may be ' � <br /> revoked at any time for due cause. 09/11/2'412 OP;16p19 � <br /> / / , <br /> Applicant Permitee Signature Date � � <br /> Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. <br />