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CITY OF ORONO 11�(�1I(I1 1 I �� II I I I 11l 1 Ill 1II M 2750 KELLEY PARKWAY DATE ISSUED: 07/03/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2875 WEAR CIR PIN : 33-118-23-34-0004 LEGAL DESC : UNPLATTED 33 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NOTE: THIS$600 ESCROW IS TIED TO DECK BUILDING PERMIT#2012-00582. WE ARE TAKING THE$600 FROM THE ORIGINAL $2500 ESCROW THAT WAS PAID FOR BUILDING PERMIT#2010-00109. APPLICANT ESCROW FEE-BUILDING 600.00 GUIMOND ET AL, SHARON R TOTAL 600.00 2875 WEAR CIR LONG LAKE,MN 55356- OWNER GUIMOND ET AL, SHARON R 2875 WEAR CIR 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 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.