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• CITY OF ORONO !,1III ! I'� t <br /> * 20 1 S - 0 1 368 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/22/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 575 OXFORD RD <br /> PIN : 05-117-23-41-0029 <br /> LEGAL DESC : KLITZKE ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$700 ESCROW IS TIED TO BUILDING PERMIT 2015-01294 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> WAMBOLD, SEAN&MELISSA <br /> Payment(s) <br /> 575 OXFORD RD CHECK 14314 700.00 <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> WAMBOLD, SEAN&MELISSA <br /> 575 OXFORD 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 assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br />