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�,i i � v. ._,�_�_ . � F C YJ 1 � r� ,v v .. , <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/02/2013 <br /> ORONO, MN �5356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1860 FOX ST <br /> PIN : 03-117-23-42-0016 <br /> LEGAL DESC : WALDRON WOODS <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIv TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: TIED TO BUILDING PERMIT#ZO12-Ol 177-PAID BY:SWANSON HOMES CK#31602 <br /> APPLICANT ESCROW FEE-BUILDING 7,500.00 <br /> SWANSON HOMES TOTAL 7,500.00 <br /> 1360 HAMEL ROAD <br /> MEDINA, MN 55340- <br /> (763)478-0320 <br /> Minnesota State License#: 627982 <br /> OWNER <br /> OLSON,MICHAEL&JENNIFER <br /> 3924 UPTON AVE S <br /> MINNEAPOLIS, MN 55410- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work fbr which this permit is issued shall be performed according to <br /> [he 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 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 if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assurin all required inspections aze <br /> requested in conformance with th tat ilding Code.This permit may be �j <br /> �evoked�Y�iv time tbr d aus ��� <br /> � �.i� �i�- � % i �7�-/ 3 <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />