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CITY OF ORONO * Z 0 1 3 - 0 0 9 5 8 * <br /> 2750 KELLEY PARKWAY �ATE 1SSUE�: 09/16/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTED ON 9/16/2013 <br /> ADDRESS : 2820 FARVIEW LA <br /> PIN : 04-117-23-34-0005 <br /> LEGAL DESC : FARVIEW <br /> : LOT 002 BLOCK 003 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2500 ESCROW IS TIED TO BUILDING PERMIT#2013-00897 -PD CHECK <br /> APPLICA1vT ESCROW FEE-BUILDING 2,500.00 <br /> SWANSON,D&A ESCROW FEE-EROSION CONTROL 0.00 <br /> 2820 FARVIEW LA <br /> LONG LAKE, MN 55356- ESCROW FEE-GRADING 0.00 <br /> TOTAL �,500.00 <br /> OWNER <br /> SWANSON, D&A <br /> 2820 FARVIEW LA <br /> LONG LAKE, MN 55�56- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this 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 erant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 assurin�all required inspections are <br /> requested in conformance with[he State Building Code.This permit may be <br /> revoked at anv time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />