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' 1 CITY OF ORONO * z 0 1 4 — 0 1 3 8 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/OU2014 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3235 GRAHAM HILL RD <br /> PIN : OS-117-23-14-0068 <br /> LEGAL DESC : GRAHAM HILL PRESERVE <br /> : LOT 4 BLOCK 1 <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 ESCROW IS TIED TO BUILDING PERMIT 2014-01206 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> ESCROW FEE-EROSION CONTROL 0.00 <br /> KILL,BOB&COUR'INEY <br /> 3235 GRAHAM HILL RD ESCROW FEE-GRADING 0.00 <br /> LONG LAKE,MN 55356- TOTAL 2,500.00 <br /> Payment(s) <br /> CHECK 3859 2,500.00 <br /> OWNER City of Orono <br /> 2750 Kelley Parkway <br /> Orono MN 55356 952-249-4600 <br /> KILL,BOB&COURTNEY <br /> 3235 GRAHAM HILL RD Receipt No: 3.G12401 Dec 1, 2014 <br /> LONG LAKE,MN 55356- <br /> Rob Kill <br /> Previous Balance: .00 <br /> Permits <br /> AGREEMENT AND SWORN STATEMENT 2014-01386 3235 Graham 2,5U0.00 <br /> Hill �d <br /> The work for which this permit is issued shall be performed according to 101-22205 <br /> the approved plans and specifications,applicable City approvals,and the Deferred Rev—Developer Deposit <br /> --------------- <br /> State Building Code. This permit is for only the work descaibed and does Total: 2,500.00 <br /> not grant permission for additional or related work which requires sepazate _______�_______ <br /> pertnits. All provisions of laws and ordinances goveming this type of work Check <br /> shall be compied with whether or not specified herein.This permit will Check No: 3859 2,500.00 <br /> expire and become null and void if construction authorized is not pay01': <br /> commenced within 180 days of the date of issuance,or if construction is ROb K I 11 <br /> suspended for a period of 180 days at any time after work has commenced. Totel Appl led: 2>500.00 <br /> The applicant is responsible for assuring all required inspections are ,00 <br /> requested in conformance with the State Building Code.This permit may be Change Tendered: _______________ <br /> revoked at any time for due cause. <br /> 12/O1/2014 03:43PM <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />