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� � CITY OF ORONO PERMIT NO.: 2009-00865 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 12/OU2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2400 FOX ST <br /> PIN : 04-117-23-41-0011 <br /> LEGAL DESC : MAJESTIC SPRUCE ADDITION <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : ESCROW FEE- WETLAND <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-WETLAND <br /> N01'E: "I'HIS ESCROW PERMI'I'IS FOK WF.,TI�AND BUFFER-TIED TO BUILDING PERMIT#2009-00803 <br /> APPLICANT ESCROW FEE- WETLAND 500.00 <br /> LINDBLOOM, JULIE <br /> 2690 RAINEY RD TOTAL 500.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> LINDBLOOM,JULIE <br /> 2690 RAINEY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMEIVT <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 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[ime 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 [ssued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />