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, CITY OF ORONO *� 4 _ 0 0 6 9 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/02/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2560 KELLY AVE <br /> PIN ; 20-117-23-11-0007 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0088 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : -RE�JS r�-�"s � �-1 c ��-i �� ( <br /> CONSTRUCTION TYPE : ESCROW FEE -TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR DEMOLITION PERMIT 201400656 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> INTN'L MINISTERIAL FELLOWSHIP Payment(s) <br /> 2560 KELLY AVE CHECK 35574 2,500.00 <br /> EXCELSIOR,MN 55331- <br /> Ci�y of Gror�c <br /> 2750 Kelley Parkway <br /> Orono MN 55356 y52-�t49--4bU0 <br /> OWNER Receipt Na: 3.011241 Jul Z, 2U14 <br /> INTN'L MINISTERIAL FELLOWSHIP <br /> 2560 KELLY AVE IntriI Ministerial F�]lowshiH� <br /> EXCELSIOR,MN 55331- <br /> Plar�niny a�.tl Zoning <br /> 2014-U0691 z560 Kelly Ave 2,500.�Ju <br /> lU1-22205 <br /> AGREEMENT AND SWORN STATEMENT Defei r�d RF.v-[)eveloper Deposi t <br /> The work for which this permit is issued shall be performed according to Tp��l: 2,��00 00 <br /> the approved plans and specifications,applicable Ciry 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 Cheek <br /> permits. All provisions of laws and ordinances goveming this type of work ChPC�: No: 35574 2,.50iJ.0U <br /> shall be compied with whether or not specified herein.This permit will Psyor: <br /> expire and become null and void ifconstruction authorized is not InTnl Ministerial Fel l ows!�iE� <br /> commenced within 180 days of the date of issuance,or if construction is Tot�,l A ]ied: 2,500.UO <br /> suspended for a period of]80 days at any time afrer work has commenced. p� <br /> The applicant is responsible for assuring all required inspections aze --- '---'�'-'--- <br /> requested in conformance with the State Building Code.This permit may be Chanye Tendered: .00 <br /> revoked at any time for due cause. ________________ <br /> p7/p��� � � r�1;COPM <br /> �7'�- / / <br /> Applicant Permitee Signature Date lssued By � nature � Date <br />