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� f CITY OF ORONO * 2 0 1 5 - 0 0 9 2 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/22/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3349 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0023 <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B <br /> : LOT O10 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO VARIANCE APPLICATION 15-3771 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> LENSING,JULIE Payment(s) <br /> 3349 CRYSTAL BAY RD CHECK 5309 2,500.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> LENSING,JUL1E <br /> 3349 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 specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> no[grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing[his 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 responsible for assuring all required inspections aze <br /> requested in conformance with[he State f3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />