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� ' CITY OF ORONO PERMIT NO.: 2011-01485 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 1U29/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 805 FOREST ARMS LA <br /> PIN : 07-]17-23-12-0009 <br /> LEGAL DESC : FOREST ARMS <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : ESCROW FEE-T1ED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$500 ESCROW IS ADDITIONAL TO THE ORtGINAL$2000 ESCROW AND TIED TO DEMO PERMIT#2011-01473 AND <br /> BUILIDNG PERMIT-#20 1 1-01 475 <br /> APPLICANT ESCROW FEE-BUILDING 500.00 <br /> GURALNIK,ALBERT& VALERIE TOTAL 500.00 <br /> 805 FOREST ARMS LA <br /> MOUND, MN 55364- <br /> OWNER <br /> GURALNIK, ALBERT&VALERIE <br /> 805 FOREST ARMS LA <br /> MOLIND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shail be performed according[o <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. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />