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` ' , CITY OF ORONO * Z 0 1 3 - 0 0 1 8 6 * <br /> � � 2750 KELLEY PARKWAY DATE ISSUED: 03/20/2013 <br /> - ORONO,MN 55356- <br /> (952 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3048 NORTH SHORE DR <br /> PIN : 09-117-23-32-0004 <br /> LEGAL DESC : CRYSTAL BAY PARK <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 13-3600-PD BY KATHRYN KALLAS <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> KALLAS,KATHRYN D ESCROW FEE-DEVELOPER 0.00 <br /> 11653 CEDAR PASS <br /> HOPKINS,MN 55343- TOTAL 2,500.00 <br /> OWNER <br /> KALLAS,KATHRYN D <br /> 11653 CEDAR PASS <br /> HOPKINS,MN 55343- <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 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 goveming 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 /> 7'he applicant is responsible for assuring all required inspections aze <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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />