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� CITY OF ORONO * 2 0 1 7 - 0 0 1 5 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/15/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 =, � <br /> ADDRESS : 701 DICKEY LAKE DR <br /> PIN : 34-118-23-22-0005 <br /> LEGAL DESC : RINGERSWOOD <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2250 ESCROW IS TIED TO BUILDNG PERMIT NUMBER 2017-00146-THE REMAINING ESCROW PAYMENT WILL BE <br /> COLLECTED WITH THE BU[LDING FEE WHEN WE ISSUE THE PERMIT FOR THE NEW STRUCTURE. WE WILL NEED TO COLLECT <br /> "I�HE ADnI"I�IONAL GSCROW AT'I'IIE TIME THF. BUILDING PRRMIT IS ISSUED. <br /> 05/15/17-2ND CK BROUGHT IN FOR DIFFERENCE. PAID BY:GONEYA HOMES-CK#14467-$250.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,250.00 <br /> ESCROW FEE-APPLICANT 250.00 <br /> GONYEA HOMES TOTAL 2,500.00 <br /> 1000 BOONE AVE N#400 Payment(s) <br /> GOLDEN VALLEY, MN 55427- CHECK 13684 2,250.00 <br /> (612)741-9069 CHECK 14467 250.00 <br /> Minnesota State License#: BUIL-2459 <br /> OWNER <br /> PUGH, PATRICK&KAREN <br /> 701 DICKEY LAKE DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this rype 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 ►80 days of the date of issuance,or if construction is <br /> suspended for a period of 1 AO 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 y time for due cause. ���'� <br /> � <br /> J '',. <br /> ' /�,� �� � l�;-� <br /> A 'cant Permitee Signature Date Issued By ignature Date <br />