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CITY OF ORONO <br />C , <br />2750 KELLEY PARKWAY <br />ORONO, MN 55356- <br />952 249-4600 FAX: (952) 249-4616 <br />ADDRESS <br />: 1473 BAY RIDGE RD <br />PIN <br />: 10-117-23-34-0005 <br />LEGAL DESC <br />: REG. LAND SURVEY NO. 0192 <br />: LOT 000 BLOCK 000 <br />PERMIT TYPE <br />ESCROW FEE — APPLICANT <br />PROPERTY TYPE <br />RESIDENTIAL <br />CONSTRUCTION TYPE <br />: ESCROW FEE — APPLICANT <br />NOTE: ESCROW PAYMENT FOR VARIANCE APPLICATION 11-3505 <br />MCCUNE, THOMAS <br />1473 BAY RIDGE RD <br />WAYZATA, MN 55391— <br />OWNER <br />MCCUNE, THOMAS <br />1473 BAY RIDGE RD <br />WAYZATA, MN 55391— <br />sl 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 />bomme aced 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 />I I <br />PERMIT NO.: 2011-00260 <br />DATE ISSUED: 04/29/2011 <br />ESCROW FEE - APPLICANT <br />TOTAL <br />700.00 <br />700.00 <br />.Applicant Permitee Signature Date —� <br />Issued By Signature Date <br />SEPARATE PER'VIITS REQUIRED FOR WORK OTHER THANT DESCRIBED ABOVE. <br />