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CITY OF ORONO *�� _ 0 0 0 7 6 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: 01125/2017 <br /> ORONO, MN 55356- <br /> �, (952) 249-4600 FAX: (952) 249-4616 <br /> A[?r�t`tESS : 669 MINNETONKA HGLD LA <br /> P 1 N : 06-11'7-23-44-0007 <br /> LEGAL DESC : MINNETONKA HIGHLANDS ESTATES <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: F.SCROW FOR NEW HOME PERMIT#20U-00073-PAID BY:OWNERS MICHAEL&MELISSA SHIELDS-CK#1178-$2,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> SHIELDS, MICHAEL&MELISSA Payment(s) <br /> 669 M[NNETONKA HGLD LA CHECK 1178 2,500.00 <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> SHIELDS, MICHAEL&MELISSA <br /> 800 LANEWOOD LANE N <br /> PLYMOUTH, MN 55447- <br /> AGREEMENT AND SWORN STATEMENT <br /> "Che 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 E3uilding 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 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 l SO days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time afrer 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 /> ` k'f) <br /> I�/l(� � �' �+ � (,l� ,,) _�C ', /��c_�f S� � � � ,�� �-� <br /> C.��-�_ <br /> Applicant Permitee Signature Date Issued By Signature Date <br />