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` CITY OF ORONO <br /> �kZO 13 - 00Z 93 * <br /> 27�0 KELLEY PARKWAY DATE ISSUED: 04/26/2013 <br /> ORONO, MN 553�6- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3210 GRAHAM HILL RD <br /> P1N : OS-117-23-11-0009 <br /> LEGAL DESC : GRAHAM HILL PRESERVE-2 <br /> : LOT 1 BLOCK 2 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTiON TYPE : ESCROW FEE-TIED TO BUILDING PERMI"I' <br /> NOTE: THIS 52�00.00 ESCRO�'1S TIED"CO BUILDING PLRMIT 2013-00292-PD CHECK#7007 <br /> APPLICANT ESCROW FEE- BUILDING 2,500.00 <br /> MESENBURG, MATT&MICHELLE ESCROW FEE-EROSION CONTROL 0.00 <br /> 2525 KELLER ROAD <br /> LONG LAKE, MN 55356- ESCROW FEE-GRADING 0.00 <br /> TOTAL �.500.00 <br /> OWNER <br /> MESENBURG, MATT&MICHELLE <br /> 2525 KELLER ROAD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work f��r ti�hich this permit is issued shall be performed accordin�to <br /> the approved plans and specifications.applicablc City approvals,and the <br /> State Buildine 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 oY 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 construct�on authorized is not <br /> commenced within 180 davs of the date of issuance,or it�construction is <br /> suspended for a period of 180 daVs at any time after wark 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 an��time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued B}� Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />