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CITY OF ORONO * Z 0 1 5 - 0 0 6 4 P1 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OS/20/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3855 BAYSIDE RD <br /> PIN : OS-117-23-23-0007 <br /> LEGAL DESC : 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 IS-3748 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> SHARRATT DESIGN <br /> 464' 2ND. ST. TOTAL 2,500.00 <br /> EXCELSIOR, MN 55331 Payment(s) <br /> CHECK 12379 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 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 sepazate <br /> permi[s. All provisions of laws and ordinances goveming[his 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 Sta[e Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Iss�ed By Signature Date <br />