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! � <br /> .� CITY OF ORONO PERMIT NO.: 2009-00476 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE �SSUEn: 08/1U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 110 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0015 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : C,OT 004 BLOCK 001 <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 ESCROW OF$2500.00 IS TIED TO BUILDING PERMIT#2009-00475 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> HOMETIME VIDEO PUBLISHING, INC. TOTAL 2,500.00 <br /> 4355 PEAVEY ROAD <br /> CHASKA,MN 55318- <br /> (952)856-46ll <br /> Minnesota State License#: 20456399 <br /> OWNER <br /> Hometime Video Publishing ' �"��t�'�_ ; <br /> .���. � �i.�J.�.'.- _ <br /> HOMETIME VIDEO PUBLISHING <br /> > <br /> <<<��t �+y�; , . <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 /> ..•. <br /> not grant permission for additional or related work which requires separate rT�•. <br /> permits. All provisions of laws and ordinances governing this type of work �; <br /> shall be compied wi[h whether or not specified herein.This permit will r„';; "''"` <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 atter work has commenced. �:"�'. �lvY f�� ''"'r� <br /> 'I'he applicant is responsible for assuring all required inspections aze ':�Y': <br /> requested in conformance with the State Building Code.This permit may be �'-�i�•''� <br /> i:, <br /> revoked at any time for due cause. <br /> / / � / / / D �'/ <br /> Applicant Permitee Signature Date Is d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />