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CITY OF ORONO I11I 11I I 1 1)1i 1!1 F 1111 1 11 1l H1 111 11 1((I III <br /> 2750 KELLEY PARKWAY * DATT> 12E ISSUED: 0820 <br /> 08/21/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1050 WILLOW VIEW DR <br /> PIN : 28-118-23-41-0011 <br /> LEGAL DESC : WILLOW VIEW <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : ESCROW FEE-WETLAND <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-WETLAND <br /> NOTE: THIS$2,000.00 ESCROW IS TIED TO PERMIT 2012-00596-WETLAND BUFFER <br /> • <br /> APPLICANT ESCROW FEE-WETLAND 2,000.00 <br /> NICKLOW,KONSTANDINOS&CRISTINA TOTAL 2,000.00 <br /> 1050 WILLOW VIEW DR <br /> LONG LAKE,MN 55356 <br /> City ,.; Orono <br /> 2750 krll>��,•' Parizray • <br /> °row krfd 55.335, S52-249-4600 <br /> OWNER Receipt No: 3.0074.73 A1. 21,:201.2 I <br /> NICKLOW,KONSTANDINOS&CRISTINA i -Nicklc <br /> 1050 WILLOW VIEW DR <br /> 01) <br /> LONG LAKE,MN 55356 Prevltue 044r:eel <br /> Peewits <br /> Z012-00820 ;.050 e,�' <br /> IE1 Or .'iryllr�liFfe!: <br /> AGREEMENT AND SWORN STATEMENT IOI ccs <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 ri7�e.i: ,r , I <br /> State Building Code. This permit is for only the work described and does I '=r"�`� '=L' <br /> not grant permission for additional or related work which requires separate tJleck <br /> permits. All provisions of laws and ordinances governing this type of work t let+ Ne: 3820 ` <br /> shall be compied with whether or not specified herein.This permit will PennS <br /> expire and become null and void if construction authorized is not 1i F1daa <br /> commenced within 180 days of the date of issuance,or if construction is T` ai ``ied t ,0(4,00 <br /> suspended for a period of 180 days at any time after work has commenced. C i nae Tendered• --- <br /> The applicant is responsible for assuring all required inspections are 04 <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. tiIr.f, 2012 11: <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />