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` � � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 2 - 0 1 1 9 6 * <br /> DATE ISSUED: 1U2U2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 80 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0018 <br /> LEGAL DESC : CREEKSIDE [N ORONO <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-T[ED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NO"1'E: THIS$2500 ESCROW IS TIED TO PERMI"1'#2012-00964-PAID BY HOMETIME VIDEO-CHGCK#1222 <br /> APPLICANT ESCROW FEE- BUILDING 2,500.00 <br /> Hometime Video Publishing Inc TOTAL 2,500.00 <br /> 4355 PEAVY RD <br /> CHASKA, MN 55318- <br /> OWNER <br /> Hometime Video Publishing Inc <br /> 4355 PEAVY RD <br /> CHASKA, MN 55318- <br /> AGREEMEIVT AND SWORN STATEMENT <br /> The work ti�r��hich this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and [he <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 compicd with whether or not specitied 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 /> requested 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 Issucd By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />