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� � ` CITY OF ORONO <br /> 2750 KELLEY PARKWAY '�` 2 0 1 6 — PJ 1 1 8 4 * <br /> DATE ISSUED: 09/23/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1225 DICKENSON ST <br /> PIN : 02-117-23-31-0048 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK 016 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING PERMIT APPLICAITON 2016-01183 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> BOULDER IMAGES TOTAL 2,500.00 <br /> 1225 DICKENSON Payment(s) <br /> WAYZATA,MN 55391- CHECK 10604 2,500.00 <br /> (651)322-7499 <br /> OWNER <br /> GIEL,TOM&SARAH <br /> 1225 DICKENSON STREET <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and speci6cations,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and dces <br /> not grant permission for additional or related work which requires separate <br /> permiu. 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 /> exp've and become null and void if construction authorized 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 the 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 />