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CITY OF ORONO * Z 0 1 4 — 0 0 9 6 7 2750 KELLEY PARKWAY DATE ISSUED: 09/09/2014 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS 200 TRUFFULA TR PIN 33-118-23-44-0039 LEGAL DESC MEADOW WOOD POND LOT 005 BLOCK 001 PERMIT TYPE ZONING PERMIT PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE LAND ALTERATION(0-500 CU YDS) NOTE: ACTUAL ESCROW FEE AMOUNT COLLECTED $2500.00 ESCROW PERMIT#:2014-00861 ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS NOTE: PRIOR TO RELEASE OF ESCROW FUNDS,AN AS-BUILT SURVEY MUST BE SUBMITTED AND APPROVED INCLUDING ITEMS SHOWN ON PROPOSED SURVEY INCLUDING GOLF GREEN AND FIRE PIT. ALL DISTURBED AREAS MUST BE REVEGETATED. INITIAL: NOTE: BUILDING PLANS AND BUILDING PERMIT APPLICATION REQUIRED FOR CONSTRUCTION OF DETACHED ACCESSORY STRUCURE,DECK AND STAIRS. INITIAL: APPLICANT MINOR LAND ALTERATION 50.00 TOTAL 50.00 ADAMS,MR.&MRS. Payment(s) 200 TRUFFULA TR CREDIT CARD 4730 50.00 LONG LAKE,MN 55356- OWNER ADAMS,DONALD&SHEILA 200 TRUFFULA TR LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. Applicant Permitee Signature Date Issued By Signature Date