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CITY OF ORONO * 2 0 1 2 — 0 0 4 5 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/12/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 1035 TONKAWA RD <br /> PIN 08-117-23-24-0004 <br /> LEGAL DESC CARLWOOD <br /> LOT 003 BLOCK 001 <br /> PERMIT TYPE ZONING PERMIT <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE LAND ALTERATION(0-500 CU YDS) <br /> NOTE: $2,000 S/B COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2000.00 <br /> HOW DID THEY PAY? CK 6033 &WHO PAID?MARIANNE BARNETT <br /> ESCROW PERMIT#:(DON'T FORGET TO ENTER) 2012-00457 <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> ACE CONCRETE CONTRACTORS INC. ENGINEERING REVIEW COSTS <br /> 18390 REVERE WAY TOTAL 50.00 <br /> PRIOR LAKE,MN 55372- <br /> (612)363-4090 <br /> OWNER <br /> BARNETT&SHARI BALLARD,MARIANNE <br /> 1035 TONKAWA RD <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 /> 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 ring all required inspections are <br /> requested in conformance 0 -the State Building Code.This permit may be <br /> revoked at any time Ifo. cause. <br /> Applic e ee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />