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CITY OF ORONO PERMIT NO.: 2010-00472 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/14/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1095 FERNDALE RD W <br /> PIN : 02-117-23-43-0023 <br /> LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-OTHER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-OTHER <br /> NOTE: TI IIS ESCROW PAYMENT OF$2500.00 WAS PAID FOR ON 5/20/2009 FOR'I,ONING APPLICA"I'ION 09-3411 <br /> ENTERED INTO PERMIT WORKS-6/14/2010 <br /> APPLICANT ESCROW FEE-OTHER 2,500.00 <br /> FOX, B& K <br /> 1095 FERNDALE RD W TOTAL 2,500.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> FOX, B& K <br /> 1095 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMEIVT <br /> The work for which this permit is issued shall be performcd 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 consVuction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring ali required inspections are <br /> requested in conformance with the State Building Code.This permit may bc <br /> revoked at any 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 />