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� � CITY OF ORONO * z 0 1 2 - 0 1 z 5 2 * <br /> 27�0 KELLEY PARKWAY DATE ISSUED: 12/18/2012 <br /> ORONO, MN 55356- <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 /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCKOW TIED TO BUILDING PERMIT#2012-01177 FOR NEW HOME,PAID BY BUILDER: SWANSON HOMES CK#30375 <br /> APPLICANT ESCROW FEE- BUILDING 2,500.00 <br /> SVb'ANSON HOMES <br /> 1360 HAMEL ROAD TOTAL �,500.00 <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 /> MINNEAPOL[S, MN 55410- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work fbr��hich this permit is issued shall be performed according to <br /> thc approved plans and specitications,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 rclated work which reyuires 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 afrer 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 /> 'evoked at any time for due se. <br /> �� � IZ / 18 / (z- l l <br /> Appl�cant Permitee Signature Date Issued Bv S' nature D <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABOV . <br />