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# � <br /> CITY OF ORONO PERMIT NO.: 2011-00169 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �ssuEn: 03/22/2011 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3300 FOX ST <br /> PIN : 0�-117-23-44-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1358 <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 /> NOTG: TI IIS$2500.00 F;SCROW PAYMGNT IS TIED TO[3UILDING PCRM[T#201 1-0010�FOR 3300 FOX STREET <br /> PAID FOR L3Y PROPER"l�Y OWNGR-WILLIAM TRUBECK <br /> APPLICANT <br /> ESCROW FEE - BUILDiNG 2,500.00 <br /> TRUBECK, WILLIAM &JUDITH TOTAL 2,500.00 <br /> 3300 FOX ST <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> TRUBECK, WILLIAM & JUDITH <br /> 3300 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc���ork tbr which this permit is issued shall be perfonned according to <br /> thc approvcd plans and specifications,applicablc City approvals,and thc <br /> State 13uilding Codc. '1'his permit is for only the work describcd and docs <br /> not grant pennission for additional or related�cork���hich requires separatc <br /> permits. nll provisions of laws and ordinances governing this type of���ork <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and becomc null and void if construction authorized is not <br /> commenccd within 180 days of the date of issuance,or if construction is <br /> suspcndcd lor a period of 180 days at any time after�vork has commenced. <br /> Thc applicant is responsible for assuring all required inspections are <br /> requested in conformance�vith the State[3uildin�Code.This pennit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> App(icant Permitee Signature Date Issucd B��Signaturc Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DGSCRIBED ABOVE. <br />