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� • CITY OF ORONO * z 0 1 2 — 0 1 1 e 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U20/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2850 SOMERSET LA <br /> PIN : 04-117-23-21-0013 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 006 BLOCK 003 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERM[T <br /> NOTE: TIED TO BUILDING PERMIT 2012-01104 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TRANGSRUD&TERRY RASMUSSEN,JON TOTAL 2,500.00 <br /> 2850 SOMERSET LA <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> TRANGSRUD&TERRY RASMUSSEN,JON <br /> 2850 SOMERSET LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[is issued shall be performed according to <br /> the approved plans and specifica[ions,applicable City approvals,and the <br /> State Building Code. This permit is for onty the work described and does <br /> not grant permission for addi[ional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied wi[h 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 conforniance with the State Building Code.This permit may be <br /> revoked at a ' �e for due cause. <br /> �l ,�"m �G / � / <br /> Appli ant P itee Signature Date Issued By nature e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. <br />