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CITY OF ORONO * Z 0 1 5 - 0 1 5 2 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/03/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3438 LYRIC AVE <br /> PIN : 17-117-23-43-0077 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 023 BLOCK 005 <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 FOR NEW HOME PERMIT#2015-01520-PD BY:FIELDSTONE FAMILY HOMES-$2,500.00-CK#6243 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> FIELDSTONE FAMILY HOMES TOTAL 2,500.00 <br /> 801 CLIFF RD E Payment(s) <br /> CHECK 6243 2,500.00 <br /> SUITE 135 <br /> BURNSVILLE,MN 55337- <br /> (952)469-8800 <br /> Minnesota State License#: BUIL-BC631164 <br /> OWNER <br /> Fieldstone Family Homes <br /> 801 CLIFF RD E <br /> SUITE 135 <br /> BURNSVILLE, MN 55337- <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 Ciry 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 cequires 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 �;'1, <br /> requested in conformance with the State Building Code.This permit may be �� � <br /> �; <br /> revoked at any time for due cause. %`' <br /> ' / �. <br /> �,� � '1 <br /> , <br /> � � � , <br /> t �� 3 , � �� ��,� � � , `�-�� �e- ����, , , i � `, <br /> Applicant Permitee Signature Date [ssued By Signature �% Date <br />