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' CITY OF ORONO * z 0 1 7 - PJ 0 5 4 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/22/2017 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2090 SHORELINE DR <br /> PIIV : 15-117-23-23-0001 `�-�—Y ��'�{ i I-� <br /> LEGAL DESC : UNPLATTED 15 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE � : RESIDENTIAL <br /> CONSTRUCTIOIV TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR DEMO PERMIT#2017-00544-PAID BY:OWNER:MARTHA HEAD-CK#ll 558-$2,500.00 <br /> REFUND TO HER MINNEAPOLIS ADDRESS: 1616 W.22ND STREET,MINNEAPOLIS, MN 55405 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> HEAD, MARTHA Payment(s) <br /> 1616 W.22ND STREET CHECK 11558 2,500.00 <br /> MWNEAPOL[S, MN 55405- <br /> OWNER <br /> HEAD, MARTHA <br /> 1616 W.22ND STREET <br /> MINNEAPOLIS, MN 55405- <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 Ihe work described and does <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 180 days of the date of issuance,or if construction is <br /> suspended for a period of I80 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 /> � 1 �. <br /> � % `� � .�. / t✓' '' <br /> � �`J?, / � �'(' { ��� � <br /> � �� L�� ��.. �I � �-- t_ � � c_c <br /> Applicant Permitee Signature Date Issued By Signature Date <br />