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~ � V MIDWESTONE BANK 85085 <br /> 72-123/739 <br /> 6117 Blue Circle Drive, Suite 101 <br /> WOODDALE Minnetonka,MN 55343 � <br /> e " � � ° E a S (g52)345-0543-(952)345-0544 S <br /> �: - <br /> � <br /> Pay: *************************Seven thousand five hundred dollars and no cents ; <br /> DATE r-J' � CHECK NO. AMOUNT <br /> May 31, 2016 85085 $******7, 5fl0 . 00 <br /> PAY � <br /> TO THE � <br /> City of Orono <br /> ORDER 'PQ $OX 6 6 <br /> oF Crystal Bay, MN 55323-0066 <br /> __ _.____. _ ; <br /> _ _ <br /> , _ _ City of Orono <br /> _--.__. ___ _ <br /> �W r�;�;-ttUlLui. 2�50 Kel ley Parkway <br /> - --__ -_ --- ----- ., Orono MN 55356 952-249-4600 <br /> WOODDALE BUI !nt(s) <br /> 6117 BLUE CR DF ` - - Receipt No: 3.015700 Jun 1, 2016 <br /> K 8508` <br /> MINNETONKA,MN 55343- <br /> (952)345-0543 Wooddale Builders <br /> Minnesota State License#:BUIL-BC002926 <br /> Planning and Zoning <br /> 2016-00620 3375 Graham 7,500.00 <br /> OWNER Hi 11 Rd <br /> 101-22205 <br /> Wooddale Builders Deferred Rev-Developer Deposit <br /> 6117 BLUE CIRCLE DR, STE 101 <br /> --------------- <br /> MINNETONKA,MN 55343- Total: 7,500.00 <br /> --------------- <br /> --------------- <br /> Check <br /> AGREEMENT AND SWORN STATEMENT Check No: 85085 7,500.00 <br /> Payor: <br /> ' The work for which this permit is issued shall be performed according to Wooddale Bui lders <br /> ' the approved plans and specifications,applicable City approvals,and the Total Appl ied: 7,500.00 <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 /> --------------- <br /> permiu. All provisions of laws and ordinances governing this type of work Change Tendered: .00 <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 06/Ol/2016 08:48AM <br /> commenced within 180 days of the 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 any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature <br />