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. . , cIT,� oF o�o�va *��� � � � 9 * <br /> 2750 ILELLEY PARKWAY DATE ISSUED: (�2/22/2012 <br /> ORONO, MN 5�356- <br /> (952) 249-4600 FA�: (9�2) 249-4616 <br /> ADDRESS : 780 BROWIv RD N <br /> PIN : �4-118-?3-11-0002 � <br /> LEGAL DESC : REG.LAND SURVEY N0. 1275 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: 1'_'-3�47 ZONING APP <br /> APPLICANT � ESCROW FEE-APPLICANT �,500.00 <br /> STAVIG, JOHN & PHOEBE TOTAL �.500.00 <br /> 780 BROWN RD N <br /> LONG LAKE; MTi 55��6- <br /> (612)625-248� � <br /> OWNER <br /> STAVIG, JOHN 8.PHOEBE <br /> 780 BROW1�' RD N <br /> LONG LAKE, MN �53�6- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be perfonned accordine to <br /> the approved plans and specifications.applicable City approvals,and the <br /> Statc Buildin�Code. This permit is for only the work described and does <br /> not�rant pemiission for additional or related w�ork which requires separate <br /> permits. All provisions of laws and ordinances�oveming this type of work <br /> shall be compied with whelher or not specified herein.This permit will <br /> exoire and become null and void if construcuon authorized is not <br /> commenced within 180 davs of the date of issuance,or if construction is <br /> suspend�ed ior a period of 180 days at an��time afrer worlc l�as commenced. <br /> Ti�e applicant is responsible for assurins all required inspections are <br /> reques[ed in conformance with tne State Builuing Code This permit may be <br /> revoked at am time for due cause. <br /> � i <br /> � i <br /> /-�pp[icant Permitee Signature Dale. � �-��,= � <br /> Issued B� Signature /=�` � Date <br /> S�PAF�AT�PERMITS REQUIRED FO�WORI�� OTHEF: THA1� D�S�RIBED ABO�'�r. � <br />