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ADDRESS <br />PIN <br />LEGALDESC <br />CITY OF ORONO <br />2750 KELLEY PARKWAY <br />ORONO, MN 55356- <br />(952) 249-4600 FAX: (952) 249-4616 <br />: 3855 BAYSIDE RD <br />: 05-117-23-23-0007 <br />: AUDITOR'S SUBD. NO. 203 <br />: LOT 063 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 15-3748 <br />II I II I : I I II 111 ii 1111 1 I I I II I I ii 11111 11: 111111 <br />*2015-00640* <br />DATE ISSUED: 05/20/2015 <br />APPLICANT <br />SHARRATT DESIGN <br />464 ' 2ND. ST. <br />EXCELSIOR, MN 55331 <br />ESCROW FEE -APPLICANT <br />ESCROW FEE -DEVELOPER <br />TOTAL <br />2 ,500.00 <br />0.00 <br />2,500.00 <br />OWNER <br />THIESSE, JOHN & SHERRI <br />3855 BAYSIDE RD <br />LONG LAKE, MN 55356- <br />AGREEMENT AND SWORN STATEMENT <br />The work for which this pennit is issued shall be perfonned according to <br />the approved plans and specifications, a pplicable City approvals, and the <br />State Building Code. This pennit is for only the work described and does <br />not grant pennission for additional or related work which requires separate <br />permits. All provisions oflaws and ordinances governing this type of work <br />s hall 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 a ll required inspection s are <br />requested in confonnance with the State Building Code. This permit may be <br />revoked at any time for due cause. <br />Applicant Permitee Signature Date <br />Payment(s) <br />CHECK <br />Issued By Signature <br />12379 2,500.00 <br />I <br />Date