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CITY OF ORONO * 2 pJ 1 7 - 0 0 2 6 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/2U2017 <br /> ,. ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4775 NORTH SHORE DR <br /> PIN : 07-117-23-32-0022 <br /> LEGAL DESC : BERGQUIST&WICKLUNDS PARK <br /> : LOT 000 BLOCK 006 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW FOR STAIRWAY TO LAKE#2017-00263-PAID BY OWNER:BEN WASSCHER-CK#4817-$2,000.00 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> WASSCHER,BEN&KATRINA TOTAL 2,000.00 <br /> 4775 NORTH SHORE DR Payment(s) <br /> MOIJND,MN 55364- CHECK 4817 2,000.00 <br /> OWNER <br /> WASSCHER,BEN&KATRINA <br /> 4775 NORTH SHORE DR <br /> MOiJND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved p(ans and specifications,applicable Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additionai or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not speci6ed 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due c,ause:—•--""""'"�_ /G� <br /> _ ' - r.--'"`""'—... <br /> �..-.--'''�,�"._ . . � 2� r? �._. � a r� -�'�. ��c �fs r� � i�l i � <br /> cant Permitee Signature Date Issued By Signature Date <br />