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CITY OF ORONO PERMIT NO.: 2011-00870 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 08/16/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 2985 WATERTOWN RD <br /> PIN 04-117-23-21-0001 <br /> LEGAL DESC AUDITOR'S SUBD.NO.230 <br /> LOT 006 BLOCK 000 <br /> PERMIT TYPE ESCROW FEE-APPLICANT Cit of Orono <br /> PROPERTY TYPE RESIDENTIAL 27j Kelley Parkway2_249-46Q0 <br /> CONSTRUCTION TYPE ESCROW FEE-APPLICANT Orono NN 557,56 <br /> Receipt No: 3.005231 Aug 16, 2011 <br /> NOTE: PAID VIA CK#5138 <br /> Richard Gheradi <br /> planning and Zoning � 000.00 <br /> 2011-00870 - Escrow s <br /> Depo1-22205sit <br /> 10 <br /> Deferred Rev-Developer Deposit----- <br /> Tot al: 21000.00 <br /> Check 2,000.00 <br /> Check No: 5138 <br /> Payor: <br /> Richard Gheradi 2 (>a0.00 <br /> Total Applied: <br /> Change Tendered: -- .00 <br /> QB/16/2011 09:5W <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> GHERARDI,RICHARD&LORI TOTAL 2,000.00 <br /> 1010 WILLOW VIEW LANE <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> GHERARDI,RICHARD&LORI <br /> 1010 WILLOW VIEW LANE <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 assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> Vol&&at any time for 7ducause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />