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� � CITY OF ORONO PERMIT NO.: 2010-00457 <br /> 2750 KELLEY PARKWAY <br /> , ORONO, MN 55356- �ATE ISSUE�: 06/1U2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2775 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0016 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 001 BLOCK 003 <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 ESCRO W PAYMENT OF$2500.00 WAS PAID ON 04/26/2010 FOR BUILDING PERMIT'S#2010-00239 AND#2010-00241 FOR <br /> A POOL AND SPORTS COURT. ENTERED INTO PERMIT WORKS ON 6/1 U2010. <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> MURLEY,TODD&MARY TOTAL 2,500.00 <br /> 2755 COUNTRYSIDE DR W <br /> LONG LAKE,MN 55356 <br /> OWNER <br /> MURLEY, TODD& MARY <br /> 2755 COUNTRYS[DE DR W <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 specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not gran[permission for additional or related work which requires separate <br /> permits. All provisions ot�laws and ordinances governing 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 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> cequested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />