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CITY OF ORONO * 2 0 1 5 - 0 0 2 8 5 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 03/10/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4415 FOREST LAKE LANDING <br /> PIN : D7-]17-23-24-0047 <br /> LEGAL DESC : TONKAVIEW GARDENS <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2,000 ESCROW IS TIED TO ZONING PERMIT 201401377 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> LINE,TIMOTHY&LORI TOTAL 2,000.00 <br /> 4415 FOREST LAKE LANDING <br /> MOUND, MN 55364 Payment(s) <br /> CHECK 7882 2,000.00 <br /> City of Orono <br /> 2750 Kelley Parkway <br /> Orono MN 5535fi 952-249-4600 ' <br /> OWNER <br /> Receipt No: 3.012928 Mar 10, 2015 ; <br /> LINE,TIMOTHY&LORI <br /> 4415 FOREST LAKE LANDING Lorie Line <br /> MOtJND,MN 55364 <br /> Previous Balance: .00 <br /> Permits <br /> 2015-00285 4415 Forest 2,OOU.00 <br /> Lake Landing <br /> AGREEMENT AND SWORN STATEMENT 101-22205 <br /> Deferred Rev-Developer Deposit <br /> The work for which this permit is issued shall be performed according to Permi ts ; <br /> the approved plans and spec�cations,applicable City approvals,and the 2014-01377 4415 Forest 50.00 <br /> State Building Code. This permit is for only the work described and dces Lake Landing <br /> 101-32520 <br /> not grant permission for additional or related work which requires separate Zoni ng Permi t <br /> permits. All provisions of laws and ordinances goveming this type of work _______________ <br /> shall be compied with whether or not specified herein.This permit will TOte l: 2,050.00 <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 CheCk <br /> suspended for a period of 180 days at any time after work has commenced. CheCk N0: 7882 2,050.00 <br /> The applicant is responsible for assuring all required inspections are Payor: <br /> Lorie Line <br /> requested in conformance with the State Building Code.This permit may be Total Appl ied: 2,050.00 <br /> revoked at any time for due cause. <br /> --------------- <br /> � Change Tendered: .00 <br /> � 03/10/2015 09:38AM � <br /> Applicant Permitee Signature Date Issued By Signarure s <br />