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�Yfr� f�-. �.;":_.. <br /> *' -• � CITY OF ORONO PERMIT NO.: 2oii-oi2�o <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEu: 10/19/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDF2ESS : 170 BIG ISLAND <br /> PIN : 23-117-23-23-0029 <br /> LEGAL DESC : MORSE ISLAND PARK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPL[CANT <br /> NOTE: GSCROW 20 1 1-0 1 23 5 <br /> ��� ��; <br /> APPLICANT �� �r���� ` � <br /> _,:,0 1� �;;;;:u• :y,�-L-�;�- <br /> 2,500.00 <br /> BACKES, STEVEN& KAREN �zp: ���: 3,fi�)573G ' C1ct 2,500.00 <br /> PO BOX 183 ' <br /> EXCELSIOR, MN 55331-0183 <br /> � Rig Island l ctili-t�1�35 1 �.�: <br /> ,�nin� �� ` � <br /> ?-f1LC1z <br /> at�d E�t, <br /> 1 OWNER `:-2�'2(i� <br /> BACKES, STEVEN& KAREN ` rf"��+ ''�� <br /> PO BOX 183 ��: . . <br /> EXCELSIOR, MN 55331-0183 —=_----•--�� <br /> ,.,�, <br /> -};: t�; SQ[� c`�5t;; <br /> _�r: <br /> AGREEMENT AND SWORN STATEMENT �i.g I5I3n� / ct`�1-1�1::3� � �1d�' <br /> The work for which this permit is issued shall be performed according to ���i��' ____.__„`'�J� <br /> the approved plans and specifications,applicable City approvals,and the ,�;�� <br /> State Building Code. "rhis permit is for only the work described and does <br /> not grant permission for additional or rela[ed work which requires separate <br /> perniits. All provisions of laws and ordinances goveming this type of work <br /> shall bc compied with whether or not specified herein.This permi[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 a[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 � <br /> revoked at any time for due cause. <br /> / / i . / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />