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CITY OF ORONO * z � 1 5 - 0 0 0 8 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU23/2015 <br /> ORONO, MN 55356- <br /> `_ -� (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 100 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0016 1� <br /> LEGAL DESC : CREEKSIDE IN ORONO • ��t 1A <br /> : LOT 005 BLOCK 001 `tp, '`� <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#20 1 5-00080-$2,500.00 PD BY OWNERS:BESIKOF <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> BESIKOF,JUSTIN&MEIRA Payment(s) <br /> 16103 CROSBY COVE CHECK 1023 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> BESIKOF,JUSTIN&MEIRA <br /> 16103 CROSBY COVE <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 [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 separa[e <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 180 days at any time after work has commenced. <br /> The applicant is cesponsible for assuring all required inspections aze <br /> requested in conformance wi[h[he State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � � - <br /> /C!i` <br /> � �.� i , ���`�„," � � �_:� �� � l �_�_ �7'y,�� i i j � 1 �� � � <br /> � �ri <br /> Applicant Permitee Si nature ate Issued By Signature Date <br />