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, CITY OF ORONO * Z 0 1 5 - 0 1 3 4 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/16/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 425 LAKEVIEW PKWY <br /> PIN : T000088 <br /> LEGAL DESC : LAKEVIEW OF ORONO <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOT'E: THIS$2500 ESCROW IS TIED TO BUILDING PERMIT#2015-01345 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> Source Land Development Inc. Payment(s) <br /> 18215 45TH AVE N CHECK 13906 2,500.00 <br /> STE D <br /> PLYMOUTH,MN 55446- <br /> (763)551-0100 <br /> OWNER <br /> Source Land Development Inc. <br /> 18215 45fH AVE N <br /> STE D <br /> PLYMOUTH,MN 55446- <br /> AGREEMENT AND SWORI�I 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 separate <br /> permits. All provisions of►aws 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />