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J J <br /> CITY OF ORONO * 2 0 1 5 - 0 PJ 4 4 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/07/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 809 BROWN RD N <br /> PIN : 27-118-23-34-0006 <br /> LEGAL DESC : UNPLATTED 27 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(501+CU YDS) <br /> NOTE: $AMOUNT TO BE DETERMWED BY CUP-SB COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000 PAID BY JARED HAFIN <br /> ESCROW PERMIT#:(DON'T FORGET TO ENTER)2015-00440 ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW <br /> COSTS <br /> C�T � <br /> DRIVEWAY RE ATION AND LANDSCAPE PERMIT <br /> ' � c�c�� <br /> NOTE: PRIOR T�SE OF ESCROW,AN AS-BUILT SURVEY AND HARDC�ALCULATIONS MUST BE SUBMITTED AND <br /> APPRO V ED. C�t—I. <br /> APPLICA[YT MAJOR LAND ALTERATION 50.00 <br /> ENGINEERING REVIEW COSTS <br /> TERRA FORMA DESIGN TOTAL 50.00 <br /> 8120 PENN AVE S,#100A <br /> BLOOMINGTON,MN 55431- Payment(s) <br /> (952)224-5000 CHECK 6130 50.00 <br /> OWNER <br /> HAHN,JERAD& LESLIE <br /> 809 BROWN RD N <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 [he <br /> State Building Code. This permit is for only the work described and does <br /> no[grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 cons[ruction authorized is not <br /> commenced within l80 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 applican[is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked ajy time for due cause. <br /> i('_' <br /> �7�l,l � � -f'�L��j � i 7 � <br /> Applicant rmitee Sign Date Issued Signature Date <br />