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CITY OF ORONO * 2 0 1 6 - PJ 0 8 8 5 * <br /> 4 , , � 2750 KELLEY PARKWAY DATE ISSUED: 07/26/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: 952)249-4616 <br /> ADDRESS : 3470 NORTH SHORE DR <br /> PIN : 08-117-23-43-0012 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO DEMOLITION PERMIT 2016-00809 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> OLSEN,BENJAMIN&KELLY Payment(s) <br /> 3470 NORTH SHORE DR CHECK 6389 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> OLSEN,BENJAMIN&KELLY <br /> 3470 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 Ciry approvals,and the <br /> State Building Code. 1'his permit is for only the work described and dces <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 suthorized 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 � <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />