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CITY OF ORONO PERMIT NO.: 2011-01168 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 09/30/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 400 WILLOW DR S <br /> PIN 03-117-23-23-0014 <br /> LEGAL DESC UNPLATTED 03 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE ESCROW FEE-APPLICANT <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING APPLICATION#11-3529 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> NELSON,ARTHUR&EDITH TOTAL 2,500.00 <br /> 400 WILLOW DR S <br /> LONG LAKE,MN 55356 <br /> OWNER <br /> NELSON,ARTHUR&EDITH <br /> 400 WILLOW DR S <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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />