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* • . <br /> CITY OF ORONO * Z 0 1 Z - 0 0 9 4 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/20/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTGD ON 9/20/2012 <br /> ADDRESS : 1900 FOX RIDGE RD <br /> PIN : 03-117-23-13-0009 <br /> LECAL 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 /> NOTE: 'I'1IIS$500 ESCIZOW IS TIED"I O PERMIT 2012-00744 FOR WF,7'LnND BUFFGR <br /> APPL[CANT ESCROW FEE- WETLAND 500.00 <br /> LINDQUIST, RUSTY& SHANNON TOTAL 500.00 <br /> 1900 FOX RIDGE RD <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 /> The work for which this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State[3uilding 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[his rype 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 after work has commenced. <br /> The applicant is responsible t�x assuring all required inspections are <br /> requested in conformance with the State[3uilding Code.This pennit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Dalc Issued By S�gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />