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� � . CITY OF ORONO * 2 0 1 Z - 0 0 1 4 9 * <br /> 27�0 KELLEY PARKWAY DATE ISSUED: 02/22/2012 <br /> ORONO, MN �53�6- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 780 BROWN RD N <br /> PIN : 34-118-23-11-0002 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1275 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLiCANT <br /> NOTE: 12-3i47"LONING APP <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> STAVIG,JOHN& PHOEBE TOTAL 2,500.00 <br /> 780 BROWN RD N <br /> LONG LAKE, MN 55356- <br /> (612)625-2485 <br /> OWNER <br /> STAVIG,JOHN & PHOEBE <br /> 780 BROWN RD N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfortned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Buildina Code. This permit is for only the work described and does <br /> not gran[permission for additional or related H�ork which requires separate <br /> permits. All provisions of laws and ordinanecs governing this type of work <br /> shall be compied with whether or not specified hereia 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 l 80 days at any time after work has commenced. <br /> The applicant is responsible for assurina all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at anv time for due cause. <br /> / / / / <br /> �lpplicant Permitee Signature Date � <br /> lssued B��Si�nature . �� 'Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO�E. <br />