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, . CITY OF ORONO * 2 0 1 6 - 0 1 0 4 1 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 08/29/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 565 FERNDALE RD N <br /> PIIV : 36-118-23-14-0004 <br /> LEGAL DESC : LINPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR NEW HOME#2016-01039-PAID BY:TRAVIS VEIT-CK#1095-$2,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> VEIT,TRAVIS Payment(s) <br /> 565 FERNDALE RD N CHECK 1095 2,500.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> VE[T,TRAVIS <br /> 565 FERNDALE RD N <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIVD SWORN STATEMENT <br /> The work for which this permit is issued shali 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. Ail provisions of laws and ordinances goveming 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 1 AO days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in con man wit te Building Code.This permit may be � <br /> � <br /> revoked at ny i�e r s . ` ij�� <br /> ��s�� �?�-�_� �;' � ���;�1 <br /> Ap ic 'ee ig ure Date Issued By Signature Date <br />