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'� � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 4 - 0 1 0 2i 7 * <br /> DATE ISSUED: 09/08/2014 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3745 SHORELINE DR <br /> PIN : 20-117-23-21-0025 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 005 BLOCK 007 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RELIGIOUS <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$700.00 ESCROW IS TIED TO ZONING PERMIT#2014-01003 <br /> APPLICANT ESCROW FEE-APPLICANT 700.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> CHURCH,GOOD SHEPHERD LUTHERAN TOTAL 700.00 <br /> 3745 SHORELINE DR I <br /> WAYZATA,MN 55391- Payment(s) <br /> CHECK II 700.00 <br /> OWNER I <br /> CHURCH,GOOD SHEPHERD LUTHERAN <br /> 3745 SHORELINE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT I <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 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 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 I <br /> revoked at any time for due cause. <br /> I / / <br /> Applicant Permitee Signature Date Issued By Signature Date I <br />