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� � CITY OF ORONO * Z pJ 1 3 — PJ 1 2 6 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/04/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1161 ELMWOOD AVE <br /> PIN : 07-117-23-14-0029 <br /> LEGAL DESC : SKARP &LINDQUISTS FERNHILL LA <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: TIED TO BUILDING PERMIT 2013-01266 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> COLFAX COMPANIES, INC. Payment(s) <br /> 206 MINNETONKA AVE S CHECK 6165 2,500.00 <br /> WAYZATA, MN 55391- <br /> (952)746-4380 City of Ororro <br /> Minnesota State License#: BUIL-BC636394 Q�n�UKel�ley��P��ay <br /> 9`,�'-249-46UU <br /> R�Qipt No: 3.G10tbc^ Dec 4, �p13 <br /> OWNER <br /> GARLOCK, MR&MRS BRUCE kichard Sur�l�f�y <br /> 1161 ELMWOOD AVE Previuus Balanc�e; <br /> MOiIND, MN 55364 Ger�its •(K1 <br /> P013-41�67 11b1 El�wood <br /> Avr �,50r1.�0 <br /> 1Gi-22205 <br /> Defierred Rev-Developer De�sit <br /> AGREEMENT AND SWORN STATEMENT <br /> Total: '---" --- <br /> The work for which this permit is issued shall be performed according ro c�5(�(j,(}O <br /> the approved plans and specifications,applicable Ciry approvals,and the Check �--"�_= <br /> State Building Code. This permit is for only the work described and does Check Plo; 616� <br /> not grant permission for additional or related work which requires separate Payor: ���•� <br /> permits. All provisions of laws and ordinances governing this type of work Richar�d Su��r9 <br /> shall be compied with whether or not specified herein.This permit will Total Appl iedt ., <br /> expire and become null and void if construction autharized is not c.��1.�} <br /> commenced within 180 days of the date of issuance,or if construction is Change Ter�dered; � _"—' <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 12104/�p13 G3:�`_--_ <br /> requested in conformance with the Sta[e Building Code.This permit may be <br /> revoked at any time for due cause. <br /> C/-3't�C--� / / <br /> Applicant Permitee Signature Date Issued By nature Date <br />