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' • CITY OF ORONO * z � 1 z - 0 a z 0 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/2U2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3516 IVY PL I <br /> PIN : 20-117-23-42-0022 <br /> LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO <br /> : LOT 000 BLOCK 000 Cit af Orono <br /> PERMIT TYPE : ESCROW FEE-APPLICANT 2�� Kelley Parkway <br /> �ino �I 55356 3�-�49-460t► <br /> PROPERTY TYPE : RESIDENTIAL Receipt t�: 3.d06561 plar �1, COI� <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> Ja�es Yhite <br /> NOTE: THIS$600.00 ESCROW IS TIED TO ZONING APPLICATION#12-3552 <br /> Planning and Zoning � <br /> 12-3552 3516 Ivy Place 600.00 <br /> 1G1-22205 <br /> Deferred Rev-Developer Dep�,sit <br /> Total: 6pp,pp <br /> Check - w_��� <br /> Check No; P3P9 60G.0(j <br /> Payor: <br /> Ja�s 1�►ite <br /> Total Applied: 60�.� <br /> Change Tendered: � .00 <br /> 031�1/201� 11:02�1� y� <br /> APPLICANT ESCROW FEE-APPLICANT 600.00 <br /> WHITE,JAMES&SHERRY ESCROW FEE-DEVELOPER 0.00 <br /> 3516 IVY PL <br /> WAYZATA,MN 55391 TOTAL 600.00 <br /> OWNER <br /> WHITE,JAMES& SHERRY <br /> 3516 IVY PL <br /> WAYZATA,MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The 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 grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.1'his 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 after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />