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CITY OF ORONO ,�c 2 0 1 5 — PJ 0 0 5 6 * <br /> � � � 2750 KELLEY PARKWAY <br /> DATE ISSUED: OU20/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4166 HIGHWOOD RD <br /> PIN : 07-117-23-44-0027 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 033 BLOCK 000 <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 ESCROW OF$2500IS TIED TO BUILDING PERMIT 2014-01230 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> CNC CONSTRUCTION,LLC ESCROW FEE-EROSION CONTROL 0.00 <br /> 4540 210TH LANE NE ESCROW FEE-GRADING 0.00 <br /> EAST BETHEL,MN 55011- TOTAL 2,500.00 <br /> (612)817-0386 Payment(s) <br /> Minnesota State License#:BUIL-BC580107 CHECK 12098 2,500.00 <br /> OWNER <br /> WILLOW CREEK,DEV <br /> P O BOX 4551 <br /> ST PAUL,MN 55104 <br /> AGREEMENT AND SWORN STATEMENT <br /> T'he work for which this pertnit is issued shall 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 gant permission for additional or related work which requires separate <br /> permits. All 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 construcdon suthorized is not <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 tt►e State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />