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~ CITY OF ORONO PERMIT NO.: 2012-00076 <br /> 2750 KELLEY PARKWAY <br /> / ORONO,MN 55356- DATE ISSUED: 02/07/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 315 TONKAWA RD <br /> PIN - : 06-117-23-14-0021 <br /> LEGAL DESC : REG.LAND SURVEY NO.0540 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> I <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: TIED TO BUILDING PERMIT 2011-01507 <br /> JENSEN HOMES APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> 601 CARLSON PARKWAY#1225 TOTAL 2,500.00 <br /> MINNETONKA,MN 55305- <br /> (952)475-0548 Ci-" of ilrvxu <br /> Minnesota State License#: 1156 017 54 <br /> 4 FSS sy <br /> ��-24g-46011 ; <br /> OWNER Ree-ipt N6.* 110NAI& Feb 7. 2012 <br /> Waycrosse,Inc. Jensen; WAes <br /> MACMILLAN,MARTHA E <br /> 15407 MCGINTRY RD W Previous' alance: f%0 <br /> WAYZATA,MN 55391- P'erv.ts <br /> 2412 06 315 Tonkma R4 2,500.00 <br /> 10t.-cc8 <br /> AGREEMENT AND SWORN STATEMENT - ]+sferred Rev-DevelOW 0465it <br /> The work for which this permit is issued shall be performed according to Total.- 2,5W.00 <br /> the approved plans and specifications,applicable City approvals,and the f "' <br /> State Building Code. This permit is for only the work described and does Check <br /> not grant permission for additional or related work which requires separate Chtrk tdo:;54169 <br /> permits. All provisions of laws and ordinances governing this type of work Payor: <br /> shall be compied with whether or not specified herein.This permit will Jerisen.Flms <br /> expire and become null and void if construction authorized is not E Total Applied: - <br /> commenced within 180 days of the date of issuance,or if construction is I <br /> suspended for a period of 180 days at any time after work has commenced. Nam e TBttitiered: <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be (tc t7+1eQ12 1d:0�?MM <br /> revoked at any time for due cause. <br /> Applicant Pennitee Signature Date Issued By S' ature to <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV <br />