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• '� CITY OF ORONO <br /> ' 2750 KELLEY PARKWAY * Z 0 1 6 - 0 PJ 1 7 4 * <br /> DATE ISSUED: 02/17/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3960 BAYSIDE RD <br /> PIN : OS-1 1 7-23-22 5396'rOOlS q��� ,r, �, <br /> ��•�;�: � ,:��,.}�.� <br /> LEGAL DESC : AUDITORS SUBD.NO. 203 �il�� <br /> : LOT O55 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: ESCROW FOR NEW HOME PERMIT#2016-00172-PAID BY:MODERN CONSTRUCTION OF MINNESOTA-CK#1418-$2,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> MODERN CONSTRUCTION OF MINNESOTA payment(s) <br /> 621 MAIN ST NW CHECK 1418 2,500.00 <br /> ELK RIVER, MN 55330- <br /> (763)200-6376 <br /> Minnesota State License#: BUIL-BC648528 <br /> OWNER <br /> LOVELESS,CHRISTOPHER&KATIE <br /> 3960 BAYSIDE RD <br /> MAPLE PLAIN,MN 55359- <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 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 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 I80 days at any time after 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 `��/�7 <br /> revoked at a y time for due cause. "' �1`�� <br /> � <br /> / � <br /> /�'/,� � �_ ) �4, � � � �/���-�� r� � �j l <br /> .l� � I._ � � <br /> App ant Permit Signature Date [ssued By Signature Date <br /> i' <br />