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� ' CITY OF ORONO * 2 0 1 6 - 0 0 2 4 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/15/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952 249-4616 <br /> ADDRESS : 565 LEAF ST <br /> pIN : OS-117-23-41-0028 <br /> LEGAL DESC : FOX HOLLOW <br /> : LOT 003 BLOCK 001 <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 TIED TO BUILDING PERMIT 2016-00129 FOR STAIRWAY CONNECTED TO HOME.PAID BY OWNER BEN GOODWIN- <br /> CK#1919-$700.00 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> GOODWIN,BEN&HEATI�R Payment(s) � <br /> 565 LEAF ST CHECK 1919 700.00 <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> GOODWIN,BEN&HEATI�R <br /> 565 LEAF ST <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. "fhis permit is for only the work described and dces <br /> not grant permission for additional or related work which requ'ves separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with wheU►er or not specified herein.This permit wiil <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 requ'ved inspections aze <br /> requested in conformance with the State Building Code.This permit may be n�. <br /> revoked at an time for due cause. _ `�L <br /> �.� ��.�`.��J� � / c� / <br /> �� <br /> Appl ermit i Date Issued By Signature Date <br />