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. • <br /> ' � CITY OF ORONO PERMIT NO.: 2009-00912 <br /> , 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- �ATE ISSUED: 12/2U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3205 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0011 <br /> LEGAL DESC : TOWNS[TE OF LANGDON PARK <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : ESCROW FEE-T[ED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTG: ESCROW AGREEMGNT"l'IED T�O BUILDiNG PERMIT 2009-0091 1 <br /> APPLICANT ESCROW FEE-BU[LDING 2,500.00 <br /> ANDERSON, R[CHARD TOTAL 2,500.00 <br /> 3205 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <br /> OWNER <br /> ANDERSON, RICHARD <br /> 3205 CRYSTAL BAY RD <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 specitications,applicable City approvals,and the <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 compied with wheiher or not specitied herein.This permit will <br /> expire and become null and void if consVuction audiorized 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 responsible for assuring all required inspections are <br /> requested in conformance with the Sta[e I3uilding 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 />