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�F <br /> 1 CITY OF ORONO * z 0 1 6 - 0 0 e 1 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/15/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 333 HOLLANDER RD <br /> PIN : 25-118-23-43-0005 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1281 <br /> : LOT 000 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: ESCROW FOR ADDITION/EXTERIOR WORK PERMIT#2016-00812-PD BY OWNERS:JOHN&DONNETTE TANNER-CK#1214 <br /> -$2,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> TANNER,JOHN&DONNETTE Payment(s) <br /> 333 HOLLANDER RD CHECK 1214 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> TANNER,JOHN&DONNETTE <br /> 333 HOLLANDER RD <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 specifica[ions,applicable City approvals,and the <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 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 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 afrer 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 /> � � ' ?.- /�� ���6 � `-� �J� ; � � , f<� � � �� /��. <br /> ,. <br /> A�lfcant P itee Signature Date Issued By Signature Date <br /> � .. <br />