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t �► CITY OF ORONO * 2 0 1 7 - 0 0 1 7 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/23/2017 � <br /> ORONO, MN 55356- �� � 1„ <br /> (952)249-4600 FAX: (952)249-4616 � <br /> ADDRESS : 2625 NORTH SHORE DR <br /> PIN : 09-117-23-42-0003 <br /> LEGAL DESC : UNPLATTED 09 117 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 APPLICATION 17-3919 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> MEHBOD,AMIR&ASHI,EY Payment(s) <br /> 2625 NORTH SHORE DR CHECK 8266 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> MEHBOD,AMIR&ASHLEY <br /> 2625 NORTH SHORE DR <br /> WAYZATA,MN 55391- <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 Buiiding 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 /> shail be compied with whether or not specified hereia 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 />