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� � . _ � CITY OF ORONO * 2 0 1 5 - 0 1 5 4 8 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 12/l U2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 795 LAKEVIEW PKWY <br /> PIN : T000108 <br /> LEGAL DESC : LAKEVIEW OF ORONO <br /> : LOT 3 BLOCK 2 <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 NEW HOME PERMIT#2015-01236-PAID BY:GONYEA HOMES-CK#10551-$2,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> GONYEA HOMES TOTAL 2,500.00 <br /> 6102 OLSON MEMORIAL HIGHWAY Payment(s) <br /> GOLDEN VALLEY,MN 55427- CHECK 10551 2,500.00 <br /> (612)741-9069 <br /> Minnesota State License#:BUIL-2459 <br /> OWNER <br /> Source Land Development Inc. <br /> 18215 4STH AVE N <br /> 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 khe work described and dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.l'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 app►icant is responsible for assuring all required inspections are � <br /> requested in conformance with the State Building Code.This permit may be � <br /> revoked at�y t�n�r due cause. <br /> /� � <br /> l f • , ��v .r <br /> I 2.- I �5 ���1 `�."�� r� � / ( � / <br /> pplicant Permitee Signature Date Issued By Signature Date <br />