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� CITY OF ORONO * 2 PJ 1 2 - 0 PJ 8 2 3 * <br /> 27�0 KELLEY PARKWAY DATE ISSUED: 08/2U2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4055 ELM ST <br /> PIN : 06-117-23-41-0106 <br /> LEGAL DESC : MINNETONKA SUMMIT PARK <br /> : LOT 000 BLOCK 009 <br /> PERMIT TYPE : ESCROW FEE-APPL[CANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIVSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW FOR FILE#12-3572 ON A LOT AREA 8:.LOT WIDTH VAI2IANCE-PD CK#1019-BY: MA"I7 FRITZ <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> FRITZ,MATT TOTAL 2,500.00 <br /> 9125 LOUISIANA AVE N <br /> BROOKLYN PARK, MN ��443- <br /> OWNER <br /> FRITZ, MATT <br /> 9125 LOU[S1ANA AVE N <br /> BROOKLYN PARK,MN 55443- <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 worh which requires separate <br /> permits. All provisions of laws and ordinances governing this 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 /> commeneed within ]80 davs of the date of issuancc,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 alI required inspections are <br /> reyuested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date ]ssued B��S�gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />