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� � • � CITY OF ORONO * 2 0 1 6 - PJ 1 0 2 8 * <br /> 2'750 KELLEY PARKWAY DATE ISSUED: 08/25/2016 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3083 FARVIEW LA <br /> PIN : 04-117-23-33-0005 <br /> LEGAL DESC : FARVIEW <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR DEMO PERMIT#2016-01027-PAID BY: SUSAN&BRENT FISCHER-CK#1595 -$2,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> FISCHER, SUSAN&BRENT TOTAL 2,500.00 <br /> 3083 FARVIEW LA Payment(s) <br /> LONG LAKE,MN 55356- CHECK 1595 2,500.00 <br /> OWNER <br /> FISCHER, SUSAN&BRENT <br /> 3083 FARVIEW LA <br /> LONG LAKE,MN 55356- <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 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. � L <br /> p . (�''J <br /> [���-�� ��-�� b�t� �S / zS/ I� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />