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� � <br /> CITYOFORONO * Z0 14 - 0fd794 * <br /> 2750 KF.LLEY YARKWAY DATE ISSUED: 07/28/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 2�19-4616 <br /> ADDRESS : 1855 CONCORDIA ST <br /> PIN : 17-117-23-22-0038 <br /> LEGAL DESC : FAGERNESS WOODS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPF. : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPL[CANT <br /> NO"1'I?: TH[S$700.00 ESCROW IS TIED TO C.U.P.APPLICnTION 14-3682 <br /> APPLICANT ESCROW FEE-APPLICANT 700.00 <br /> ESCROW FEE- DEVELOPER 0.00 <br /> KELLY, JAMES& MARGARET TOTAL 700.00 <br /> 1855 CONCORDIA S. Payment(s) <br /> WAYZATA, MN 55391- CHECK 8252 700.00 <br /> OWNER <br /> KELLY, JAMES& MARGARET <br /> 1855 CONCORD[A S. <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfonned according to <br /> the approvcd plans and specifications,applicable City approvals,and dre <br /> State Building Code. This permit is for only the work dcscribed and does <br /> not grant permission 1or additional or related work which requires separate <br /> pcnnits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This pennit will <br /> expire and becomc null and void iY construction authorized is not <br /> commenced within 180 days ofUic date of issuance,or it�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 contormance with the State Building Code."I�his permit may bc <br /> revoked at any time for due cause. <br /> / / <br /> npplicant Permitee Signature Date Issued I3y Signature Date <br />