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• , CITY OF ORONO <br /> • * Z 0 1 2 — P1 0 8 5 0 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 08/28/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2280 FOX ST <br /> PIN : 03-117-23-32-0014 <br /> LEGAL DESC : BILL KELLEYS LAND 1 ST DN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE- WETLAND <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE- WETLAND <br /> � <br /> NOTE: THIS$5,000.00 ESCROW IS�I'IGD TO f3ULDWG PERMIT-2012-007�FOR WETLAND E3UFFER <br /> APPLICANT ESCROW FEE- WETLAND 5,000.00 <br /> KUHL DESIGN& BUILD, LLC TOTAL 5,000.00 <br /> 1515 STH STREET SOUTH <br /> HOPKINS, MN 55343- <br /> (952)935-9469 <br /> Minnesota State License#: BC390161 <br /> OWNER <br /> MYHRAN,ANDERS& LYNN <br /> 2280 FOX ST <br /> LONG LAKE, MN 55356- <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 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 compicd with whether or not specified herein.This permit will <br /> expire and become null and void if construction au[horized 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 assuring all required inspections are <br /> requested in conformance with the State E3uilding Code.This permit may be <br /> revoked at any time for due causc. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />