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, ` CITY OF ORONO * 2 0 1 5 - 0 0 7 7 0 * <br /> " � 2750 KELLEY PARKWAY DATE ISSUED: 06/15/2015 <br /> ORONO, MN 55356- � r� <br /> (952 249-4600 FAX: 952 249-4616 VC �� <br /> ADDRESS : 405 NORTH ARM DR <br /> PIN : 06-117-23-32-0003 <br /> LEGAL DESC : UNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW FOR REMEDIATION OF MERCURY-PAID BY SOURCE LAND DEVELOPMENT,INC.-CK#238528-$20,000.00 <br /> APPLICANT ESCROW FEE-EROSION CONTROL 20,000.00 <br /> Source Land Capital Pa ment s TOTAL 20,000.00 <br /> 18215 45TH AVE N, STE D y � � <br /> PLYMOUTH,MN 55446- CHECK 238528 20,000.00 <br /> (763)551-0100 <br /> OWNER <br /> Source Land Capital <br /> 18215 45TH AVE N, STE D <br /> PLYMOUTH,MN 55446- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit 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 sepazate <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 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 /> IfC� <br /> / (�e.c� dl�l-�"` 0 i f�c� (� i! S� 1 S <br /> Applicant Permitee Si a ure Date Issued By Signatur Date <br /> ✓ ,,,C.a,r,ru,� f- <br />