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• � CITY OF ORONO * z 0 1 5 - 0 0 1 z 8 * <br /> � � � � 2750 KELLEY PARKWAY DATE ISSUED: O1/29/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3460 BIRCH LA <br /> PIN : 08-117-23-43-0027 <br /> LEGAL DESC : LYDIARDS PARK LAKE MTKA <br /> : LOT 019 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 /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> LISLE, STEVE&ANGELA ESCROW FEE-EROSION CONTROL 0.00 <br /> 3460 BIRCH LA ESCROW FEE-GRADING 0.00 <br /> WAYZATA,MN 55391- TOTAL 2,500.00 <br /> Payment(s) <br /> CHECK 3089 2,500.00 <br /> OWNER <br /> LISLE, STEVE&ANGELA <br /> 3460 BIRCH LA <br /> WAYZATA,MN 55391- <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This percnit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />