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'� '�'� CITY OF ORONO <br /> 2750 KELLEY PARKWAY * Z 0 1 5 - 0 0 9 8 6 * <br /> DATE ISSUED: 02/22/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1180 LOMA LINDA AVE <br /> PIN : 08-117-23-23-0002 <br /> LEGAL DESC : LJNPLATTED 08 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING PERMIT 2015-00985 � l��I uu ���� ��,3 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> BURNS,MATTHEW TOTAL 2,500.00 <br /> 1180 LOMA LINDA AVE Payment(s) <br /> MOIJND,MN 55364 CHECK 2422 2,500.00 <br /> OWNER <br /> BURNS,MATTHEW <br /> 18660 AZURE ROAD <br /> DEEPHAVEN,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued sha11 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 does <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 /> 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 />