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, CITY OF ORONO * z 0 1 6 - 0 1 z 0 0 * <br /> 2750 KELLEY PARKWAY pATE [SSUED: 09/26/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 758 BRIDGEWATER DR <br /> PIN : 33-118-23-11-0133 <br /> LEGAL DESC : STONEBAY FOURTH ADDITION <br /> : LOT 16 BLOCK 1 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CO1vSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTG: THIS$2500 ESCROW IS TIED TO BUILDING PERMIT 2016-01036 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> Stonebrook Development LLC Payment(s) <br /> 17149 LINCOLN ST NE CHECK 85724 2,500.00 <br /> HAM LAKE, MN 55304- <br /> OWNER <br /> Stonebrook Development LLC <br /> 17149 LINCOLN ST NE <br /> HAM LAKE, MN 55304- <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 Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related�vork which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not speci6ed herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date o1'issuance,or if construction is <br /> suspended for a period of l80 days at any time atter 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 any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />