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CITY OF ORONO * Z 0 1 4 — fd 1 0 0 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/15/2014 <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 : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> NOTE: $700 SB COLLECTED IN ESCROW FEE <br /> ESCROW PERMIT#:2014-01007 <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS <br /> MINOR LAND ALTERATION-WALL-PHASE II <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> RETAINING WALL<4' S0.00 <br /> CHURCH,GOOD SHEPHERD LUTHERAN TOTAL 100.00 <br /> 3745 SHORELINE DR Payment(s) <br /> WAYZATA, MN 55391- CHECK 3029 (�,,100.00 <br /> OWNER <br /> CHURCH,GOOD SHEPHERD LUTHERAN <br /> 3745 SHORELINE DR <br /> WAYZATA,MN 55391- <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 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 governing 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 <br /> revoked at any time for due cause. <br /> � ,,�-�� <br /> Applicant Permitee Signature Date Iss By Signature Date <br />