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'� '�► CITY OF ORONO <br /> * 2 0 1 4 — 0 0 6 3 6 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/19/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 4440 FOREST LAKE LANDING <br /> PIN 07-117-23-24-0017 <br /> LEGAL DESC TONKAVIEW GARDENS <br /> : LOT 012 BLOCK 000 <br /> PERMIT TYPE ZONING PERMIT <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE LAND ALTERATION(0-500 CU YDS) <br /> NOTE: $2,000 S/B COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2000.00 <br /> HOW DID THEY PAY? CHECK &WHO PAID?JOE CHURCH <br /> ECROW PERMIT#:(DON'T FORGET TO ENTER) c20/5= !e0&02.0 <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> TOTAL 50.00 <br /> CHURCH,JOSEPH <br /> 6175 STONE COURT Payment(s) <br /> CHECK 1292 50.00 <br /> INDEPENDENCE,MN 55359- <br /> (612)308-7482 <br /> OWNER <br /> CHURCH,JOSEPH <br /> 6175 STONE COURT <br /> INDEPENDENCE,MN 55359- <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 /> AppliMnt Permitee Signature Date Issued Wy Signature Date <br />