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CITY OF ORONO � 1 4 - 0 1 1� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/29/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1855 CONCORDIA ST <br /> PIN : 17-117-23-22-0038 <br /> LEGAL DESC : FAGERNESS WOODS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE ; ESCROW FEE -TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCRO W FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$1300 ESCROW IS TIED TO BUILDING PERMIT#2014-01104 <br /> APPLICANT ESCROW FEE-BUILDING 1,300.00 <br /> ESCROW FEE-EROSION CONTROL 0.00 <br /> KELLY, JAMES&MARGARET ESCROW FEE-GRADING 0.00 <br /> 1855 CONCORDIA S. TOTAL 1,300.00 <br /> WAYZATA, MN 55391- <br /> Payment(s) <br /> CHECK 8276 1,300.00 <br /> OWNER <br /> KELLY, JAMES&MARGARET <br /> 1855 CONCORDIA S. <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his 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 /> 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 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � 9 ,�� , � <br /> Applicant Permitee Signature Date Issu By Signature Date <br />