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� CITY OF ORONO PERMIT NO.: 2011-01476 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 1 v23/2011 <br /> 952 249-4600 FAX: 9�2 249-4616 <br /> ADDRESS : 805 FOREST ARMS LA <br /> PIN : 07-117-23-12-0009 <br /> LEGAL DESC : FOREST ARMS <br /> : LOT 001 BLOCK 002 <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#2011-01473-PD CK#3137 ON 1 U23/11 BY:ALBERT GURALNIK <br /> APPLICANT ESCROW FEE-BUILDING 2,000.00 <br /> GURALNIK,ALBERT&VALERIE TOTAL 2,000.00 <br /> 805 FOREST ARMS LA <br /> MOLJND, MN 55364 <br /> OWNER <br /> GURALNIK,ALBERT&VALERIE <br /> 805 FOREST ARMS LA <br /> MOLJND, MN 55364 <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 additionaf 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 a[any time after work has commenced. <br /> The applicant is responsible fo suring all required inspections are <br /> requested in conformance the State Building Code.This permit may be � <br /> revoked a �time fo ausa <br /> l/ iZ3 iZo// cYi" `��c / ��-z3 -1 <br /> Appl cant Pe ' ee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />