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CITY OF ORONO * Z 0 1 4 — P1 1 3 7 7 * <br /> , � 2750 KELLEY PARKWAY DATE 1SSUED: 03/10/2015 <br /> , ORONO, MN 55356— <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4415 FOREST LAKE LANDING <br /> PIN : 07-117-23-24-0047 <br /> LEGAL DESC : TONKAVIEW GARDENS <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZOMNG PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) � �.� �,v <br /> , � <br /> NOTE: $2,000 COLLECTED[N ESCROW FEE -PD BY CHECK#7882 BY LORIE LINE-PERMIT#2015-00285 �'� �l <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS �i ,.�'� <br /> . `�,I <br /> NOTE: AS-BUILT SURVEY TO BE SUBMITTED. INITIAL: , <br /> NOTE: COORDINATF.WITH OWNER AT 4440 FOREST LAKE LANDING REGARDING THE PROJECT WORK AND TIMING: IN[T[AL: <br /> APPL[CANT MINOR LAND ALTERATION 50.00 <br /> ENGINEERING REVIEW COSTS <br /> LINE,TIMOTHY&LORI TOTAL 50.00 <br /> 4415 FOREST LAKE LANDING <br /> MOUND,MN 55364 Payment(s) <br /> CHECK 7882 50.00 <br /> OWNER <br /> LINE, TIMOTHY&LORI <br /> 4415 FOREST LAKE LANDING <br /> MOUND, MN 55364 <br /> AGREEMEIVT 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 additional or related work which requires sepazate <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 for assuring all required inspections are <br /> requested in conformance with[he State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> , <br /> /G�'v� �,% 1/d"1k- _ � ,'^� �� �� � � / �j � <br /> Applicant Permitee Signature Date� Issued y Signature Date <br />