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• , <br /> CITY OF ORONO * 2 0 1 6 - 0 1 1 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/20/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1920 FAGERNESS POINT RD <br /> PIN : 17-117-23-23-0031 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 027 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIVSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> N01'E: TH[S$2500 ESCROW IS TIEDT O ZONING APPLICATION 16-3866 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> DAUM,GEORGE Payment(s) <br /> 1920 FAGERNESS PT RD CHECK 2079 2,500.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> DAUM, GEORGE <br /> 1920 FAGERNESS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT 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 Ihe 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 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 iY construction is <br /> suspended for a period of l80 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 any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />