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. CITY OF ORONO * 2 0 1 4 - 0 1 0 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4565 BAYSIDE RD <br /> PIN : 06-117-23-21-0005 <br /> LEGAL DESC : UNPLATTED 06 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTG: THIS$2500 ESCROW 1S TIED TO LAND USE PERMIT- 14-3694 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> RENNEBOHM, PETER& SHARON <br /> 4565 BAYSIDE RD TOTAL 2,500.00 <br /> MAPLE PLAIN, MN 55359- Payment(s) <br /> CHECK 1791 2,500.00 <br /> OWNER <br /> RENNEBOHM, PETER& SHARON <br /> 4565 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his permit is issued shall be pertormed according to <br /> the approved plans and specifications,applicable City approvals,and die <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."I'his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of[he 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 Yor assuring all required inspec[ions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date lssued By Signature Date <br />