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' • CITY OF ORONO * z 0 1 3 - 0 0 3 1 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/02/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1165 BROWN RD S <br /> PIN : 10-117-23-24-0020 <br /> LEGAL DESC : LTNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <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 BUILDING PERMIT 2013-00235-PAID CHECK#9379 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> NIELSEN,ERIC ESCROW FEE-EROSION CONTROL 0.00 <br /> P.O.BOX 54 <br /> CRYSTAL BAY,MN 55323- ESCROW FEE-GRADING 0.00 <br /> TOTAL 2,500.00 <br /> C��Y �?r 4:3nG�r�. <br /> � [.�i�` ����£�' i'`dt'4,"tV��' � <br /> OWNER ' �1t�vr� � �;s�f& ��+��::�� a�;r�;t; <br /> j . , <br /> NIELSEN,ERIC ft•b����� 1�'::t 5.!1��.7,�-, � � ;,-r� <br /> P.O.BOX 54 ; �y � `�"`' <br /> CRYSTAL BAY,MN 55323- ; r . , <br /> :£firli:i?]� � �f lr �,��' .�;t; : " <br /> 'r � � � <br /> ; >tY1:�Vtf+.t� �?3i:.YR:.'�: `�n: � <br /> AGREEMENT AND SWORN STATEMENT ' ���p`�';-��3+ t ° � ' ` <br /> ' 4iYS,.y"q+�./C.':r.� 1 F t�7 ti::"c.'tf:i iS� : '•' �:� �.1 I <br /> The work for which this permit is issued shall be performed according to � a ; '�`�'3` � i <br /> the approved plans and specifications,applicabie Ciry approvals,and the � ;t��-�r�d{:� ; <br /> State Building Code. This permit is for only the work described and does �'E�s e�3.�ni�-�-�V�ij��� {)z�5t,* <br /> not grant permission for additional or related work which requires sepazate �..,,.. <br /> permits. All provisions of laws and ordinances governing this type of work �� ��i%d�a a f� r„ , ,�.�� <br /> shall be compied with whether or not specified herein.This permit will ' _ '9-� ��- <br /> expire and become null and void if construction authorized is not ����K �� � , <br /> commenced within 180 days of the date of issuance,or if construction is �f�=�` {�` �:����� �,;�(�r� 4>.�1 <br /> ��a'4Y`: • i <br /> suspended for a period of 180 days at any time after work has commenced. 4 � <br /> The applicant is responsible for assuring all required inspections are � ����r ���' '- ���'= �`�'���� - 1 <br /> e�Jb?� n�a�el.�P.�r � 5 r <br /> requested in conformance with the State Building Code.This permit may be �',`_+�•�l,°y�} ' � <br /> revoked at ariy time for due cause. r�����4�, m '- ! <br /> •�Y�s�'f`x?�'; �:�1.. <br /> / / ` t�a�'�." c'��' �r� f�s!''« � �— <br /> Applicant Permitee Signature Date � Issued By Signature � �� � ._ � <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />