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CITY OF ORONO <br />2750 KELLEY PARKWAY <br />ORONO, MN 55356- <br />PERMIT NO.: 2010-00468 <br />DATE ISSUED: 06/14/2010 <br />ADDRESS <br />PIN <br />LEGALDESC <br />(952) 249-4600 FAX: (952) 249-4616 <br />: 1635 BORNS POINT RD <br />: 17-117-23-11-0006 <br />: REG. LAND SURVEY NO. 0565 <br />: LOT 000 BLOCK 000 <br />PERMIT TYPE : ESCROW FEE -OTHER <br />PROPERTY TYPE : RESIDENTIAL <br />CONSTRUCTION TYPE : ESCROW FEE -OTHER <br />NOTE: THIS ESCROW PAYMENT OF $2500.00 WAS PAID FOR ON 6/17/2009 FOR ZONING APPLICATION 09-34 17 <br />ENTERED INTO PERMIT WORKS ON 6/14/2010 <br />APPLICANT <br />MOSELEY, STEPHEN & SUSAN <br />1635 BORNS PT RD <br />WAYZATA, MN 55391- <br />OWNER <br />MOSELEY, STEPHEN & SUSAN <br />1635 BORNS PT RD <br />WAYZATA, MN 55391- <br />AGREEMENT AND SWORN STATEMENT <br />The work fo r which this permit is issued shall be performed according to <br />the approved plans and specifications, app li cable 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 wh ich requires separate <br />permits. All provisions oflaws a nd ordinances governing this type of work <br />shall be compied with whether or not specified herein . Thi s 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 app licant is re sponsible for assu rin g all required inspections are <br />requested in conformance with the State Building Code. This permit may be <br />revoked at an y time for due cause. <br />Applicant Permitee Signature Date <br />ESCROW FEE -OTHER <br />TOTAL <br />Issued By Signature <br />SEP ARA TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />Date <br />2,500.00 <br />2,500 .00