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CITY OF ORONO * z 0 1 7 - 0 0 0 6 � <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU24/2017 <br /> ORONO, MN 55356- <br /> , (952) 249-4600 FAX: (952) 249-4616 <br /> ADD:C'ESS : 2995 DEER RUN TR <br /> P[N : 04-117-23-23-0030 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERM[T <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BU[LDING PERMIT <br /> NO"I�E: ESCROW FOR BU[LDING ADDIT[ON#2017-00067-PAID BY:OWNER KELLY LE[SCHOW,CK#6207-$2,500.00 <br /> APPL[CANT ESCROW FEE-BUILD[NG 2,500.00 <br /> TOTAL 2,500.00 <br /> LEISCHOW, KELLY Payment(s) <br /> 2995 DEER RUN TR CHECK 6207 2,500.00 <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> LEISCHOW, KELLY <br /> 2995 DEER RUN TR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMEKT <br /> 'I�he work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and Ihe <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. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied 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 conshuction 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 /> � «� <br /> � � <br /> ',�, �� ,C, r �-l�- �..7 �-'�c�.-�-� � ��-f��� � � �y� �- <br /> Applicant Permit ign ture Date Issued By Signature Date <br />