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. � CITY OF ORONO PEaM1T No.: 2011-ooiis <br /> 2750 KELLEY PARKWAI' <br /> ORONO, MN 5�3�6- DATE ISSUED: 02/22/2011 <br /> (9�2 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 120 CREEk RIDGE PASS <br /> PIN . 03-117-23-12-0014 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 003 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: ESCROW FOR NEW(-IOME BUILDING PERMIT#2011-00100 <br /> APPLICANT <br /> ESCROW FEE- BUtLDING 2,500.00 <br /> GUSTAFSON, MICHAEL R. SUSAN <br /> 1000 SHELARD PKWY#300 TOTAL 2,500.00 <br /> MINNEAPOLIS, MN 5>426- <br /> OWNER <br /> GUSTAFSON, MICHAEL& SUSAN <br /> 1000 SHELARD PKWY#300 <br /> MINNEAPOLIS,MN 55426- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perf�ormed according to <br /> the approved plans and specifications,applicable Cit�approvals,and the <br /> State Buildin�Code. This pennit 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�overning this type of work <br /> shall bc compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenccd within 180 davs of the date of issuance.or if construction is <br /> suspended for a period of I 80 days at am�time after work has coinmenced. <br /> The applicant is responsible for assurin��all required inspections are <br /> requested in confonnance with thc State Buildins Code.This permit inay be <br /> revoked at any time for due cxuse. <br /> / / / / <br /> Applicant Permitee Signature Datc Issued B��Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAt�' DESCRIBED ABOVE. <br />