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CITY OF ORONO * z 0 1 7 - 0 0 z 0 0 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: 03/03/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ��DRESS . 1480 S[XTH AVE N <br /> PIN : 26-118-23-32-0008 <br /> LEGAL DESC : DOUGLAS ESTATES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW FOR SEiED#2017-00198-PAID BY OWNER: DANIEL GULQRANDSON-CK#8175 -$2,500.00 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> GULBRANDSON, DAN&ERICKA Payment(s) <br /> 1480 SIXTH AVE N CHECK 8175 2,500.00 <br /> LONG LAKE, MN 55356- <br /> OWIYER <br /> GULBRANDSON, DAN & ERICKA <br /> 1480 SIXTH AVE N <br /> LONG LAKE,MN 55356- <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 /> noi 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 1 AO days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> rcquested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. ` ,, <br /> , � <br /> ,3 . J�-� �c i%��-;-��-- , =�, �:�.-T <br /> —�v� �� I 11 <br /> Applicant Per itee Signature Da e Issued By Signature Date <br />