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CITY OF ORONO * 2 0 1 3 - 0 1 0 2.9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/Ol/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 75 LEAF ST <br /> PIN : OS-117-23-11-0014 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 3 <br /> : LOT 1 BLOCK 3 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> KAPSNER,JASON&NLIE TOTAL 2,500.00 <br /> 760 DICKEY LAKE ROAD <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> KAPSNER,JASON&NLIE <br /> 760 DICKEY LAKE ROAD <br /> LONG LAKE,MN 55356- <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 governing 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 /> 'Th�plicant is responsible for assuring all required inspections are <br /> equest�d.in conformanc with the State Building Cod�This permit may be <br /> voked tr`� u cause. �` I � �� <br /> *~•. :' " `/ / <br /> � � <br /> A plicant��ermitee Signatur Date Issue y ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED.4�OV <br />