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CITY OF ORONO * 2 B 1 5 - 0 0 PJ 9 5 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OU23/2015 <br /> ` � �� ORONO, MN 55356- <br /> V (952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 763 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0091 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 4 BLOCK 1 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2500 ESCROW IS TIED TO BUILD[NG PERMIT#2015-00094 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> ESCROW FEE- EROSION CONTROL 0.00 <br /> WOODDALE BUILDERS INC. ESCROW FEE-GRADING 0.00 <br /> 6117 BLUE CR DR <br /> MINNETONKA,MN 55343- TOTAL 2,500.00 <br /> (952)345-0543 Payment(s) <br /> Minnesota State License#: BUIL-BC002926 CHECK � 2,500.00 <br /> 1 �a,�9 <br /> OWNER <br /> Stonebrook Development LLC II VIwJ'�- <br /> 6117 BLUE CIRCLE DRNE ����� <br /> MINNETONKA, MN 55343- <br /> 6n�y c�i�ec�� <br /> ^ � <br /> AGREEMENT AND SWORN STATEMENT 1�('(�'��/ �A�" <br /> ��r v�v '�Cil <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 permi[is fot only the work described and does ��I'� <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 whe[her 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 /> reques[ed in conformance with the Sta[e Building Code.This permit may be <br /> revoked at any time f e cause. <br /> �/, � � -Z3- �5 � Q � <br /> �� <br /> Applicant Permitee Signature Date Issue y Signature Date <br />