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• CITY OF ORONO * Z 0 1 4 - 0 PJ 4 8 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 0�/20/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2690 FOX ST <br /> PIN : 04-117-23-42-0003 <br /> LEGAL DESC : AUDITOR'S SUBD. NO. 229 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2500 ESCROV✓IS"T'IED TO BUILDING NERMIT 2014-00298 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> ESCROW FEE-EROSION CONTROL 0.00 <br /> JACOBSON, MICHAEL ESCROW FEE-GRADING 0.00 <br /> 2690 FOX ST <br /> WAYZATA, MN 55391- , TOTAL 2,500.00 <br /> Payment(s) <br /> CHECK 6468 2,500.00 <br /> OWNER <br /> JACOBSON, MICHAEL <br /> 2690 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work fbr which this permit is issued shall be performed according to <br /> the approved plans and specifications,applieable 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 hccome null and void if construction authorized is not <br /> commenced within 180 days of[he 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 Building Code.This permit may be <br /> revoked at anv time for duc cause. <br /> / / <br /> Applicant Permitee Signature Date Issucd B}'Signature Datc <br />