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' � R CITY OF ORONO <br /> * 2 0 1 3 - P10 2 2 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/08/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4495 BAYSIDE RD <br /> PIN : 06-117-23-21-0004 <br /> LEGAL DESC : UNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-OTHER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-OTHER <br /> NOTE: THIS$7500 ESCROW IS I'OR A TEMPORARY CERTIFICATE OF OCCUPANCY-PD CHECK#5749 <br /> APPLICANT ESCROW FEE-OTHER 7,500.00 <br /> Katherine Taylor Homes, Inc. <br /> P.O. BOX 35 TOTAL 7,500.00 <br /> LORETTO, MN 55357- <br /> OWNER <br /> Katherine Taylor Homes, Inc. <br /> P.O. BOX 35 <br /> LORETTO, MN 55357- <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 addi[ional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shal)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 afrer 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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Signatare Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />