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' ' ' CITY OF ORONO * z 0 1 2 — fd 0 9 4 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUEll: 09/20/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (9�2) 249-4616 <br /> ADDRESS : 1900 FOX RIDGE RD <br /> PIIv : 03-117-23-1�-0009 <br /> LEGAL DESC : FOX RIDGE <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-WETLAND <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-WETLAND <br /> NO"IE: THIS$500 ESCROW IS TIED TO PERMIT 2012-00744 FOR WETLAND BiJFFER <br /> APPLICANT ESCROW FEE- WETLAND 500.00 <br /> LINDQUIST, RUSTY& SHANNON <br /> 1900 FOX RIDGE RD TOTAL 500.00 <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> LINDQUIST, RUSTY& SHANNON <br /> 1900 FOX RIDGE RD <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> 7'he 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 Buildino Code. This permit is for only the work described and does <br /> not grant permission ior additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whe[her or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 davs of the date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time after 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 anv time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date lssued B��Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />