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CITY OF ORONO * z 0 1 5 - 0 1 z 0 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 10 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0009 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 00] 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#2015-01198-PD BY CHAMBERLAIN FINE CUSTOM HOMES-CK#934-$2,500.00 <br /> APPLICANT ESCROW FEE- BU[LDING 2,500.00 <br /> TOTAL 2,500.00 <br /> CHAMBERLAIN FINE CUSTOM HOMES Payment(s) <br /> 11578 CHAMBERLAIN CT CHECK 934 2,500.00 <br /> EDEN PRAIRIE, MN 55344- <br /> (952)649-7653 <br /> Minnesota State License#: BUIL-BC661410 <br /> OWNER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLAIN CT <br /> EDEN PRAIRIE,MN 55344- <br /> AGREEMENT A1vD 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. This permit is for onty 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 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 aze � <br /> requested in conformance with the State Building Code.This permit may be , CC C� <br /> revoked at any time for due cause. � <br /> �� f' �� � � �� ��_.�� � ��.�:�� 5��� �� / � _ <br /> ��%.�_ �/i -� ; � _ � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />