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CITY OF ORONO * z 0 1 5 - 0 0 3 3 4 * <br /> � ' 2750 KELLEY PARKWAY DATE ISSUED: 03/23/2015 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 905 FERNDALE RD W <br /> PIN : 02-117-23-44-0010 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. 184 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPL[CANT <br /> NOTE: ESCROW FOR'T.ONING FILE#15-3727,LOT LINE REARRANGEMENT-$2,500 PD BY JOHN BROOKS,CK#10277 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> BROOKS,JOHN&JOAN Payment(s) <br /> 905 FERNDALE RD W CHECK 10277 2,500.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> BROOKS, JOHN&JOAN <br /> 905 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIYD 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 gran[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 wi[h 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 da[e of issuance,or if 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � �lJ s <br /> ���C;u( G�-Lt_�� 1���-� < <`-7������E�� � :� ,�:�; , / <br /> Applicant Permitee Signature' Date Issued By Signature Date <br />