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. - "' • ` CITY OF ORONO <br /> 2750 KELLEY PARKWAY '�` 2 0 1 6 — 0 1 0 0 4 * <br /> DATE ISSUED: 08/19/2016 <br /> ORONO,MN 55356- <br /> ' (952)249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1940 SHORELINE DR <br /> PIN : 10-117-23-42-0007 <br /> LEGAL DESC : ELBRIDGE S BARNES 1 ST SUBD 10- <br /> : LOT 005 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW FOR ZONII�IG PERMIT#2016-00988-PD BY:ALAN&ANNE NETTLES-CK#15838- $2,000.00 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> TOTAL 2,000.0(1 <br /> NETTLES,ALAN&ANNE Payment(s) <br /> 1940 SHORELINE DR CHECK 15839 2,000.00 <br /> WAYZATA,NIN 55391- <br /> OWNER <br /> NETTLES,ALAN&ANNE <br /> 1940 SHORELINE DR <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pern►it is issued shall be performed according to <br /> the approved plans and speciScadons,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and dces <br /> not grant permission for addirional or related work which requires separate <br /> permiu. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.l'his 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 aze <br /> requested in confortnance with the State Building Code.1'his permit may be ,/��„ <br /> revoked at any time for due cause. J u�� <br /> �' � � I'�-�ti �/ / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />