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� ' � ' � ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 4 - P1 0 0 3 P1 * <br /> DATE ISSUED: OU09/2014 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2605 KELLY AVE <br /> PIN : 20-117-23-14-0022 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 005 BLOCK 005 <br /> PERMTT TYPE : ESCROW FEE-'TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUII,DING PERMIT <br /> NOTE: THIS$2500 ESCROW IS T'IED TO BUILDING PERMIT#201400029 ��A 1 �� <br /> U`�`� � <br /> 0��� <br /> � <br /> APPLICANT ESCROW FEE-BUII..DING 2,500.00 <br /> TOTAL 2,500.00 <br /> WINE,SCOTT&JILL Payment(s) <br /> 2587 KELLY AVE CHECK 3045 2,500.00 <br /> EXCELSIOR,MN 55331- <br /> OWNER <br /> WINE,SCOTT&JILL <br /> 2587 KELLY AVE <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pecmit 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 dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming tlus 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 atter work has commenced. <br /> The applicant is responsible for asswing 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 /> App icant Permitee Signahue Date Issued By Signature Date <br />