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• . CITY OF ORONO I I' I II IL ILI <br /> * 20 1 7 - 0 1 473 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/13/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 649 FERNDALE RD W <br /> PIN : 02-117-23-44-0003 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. 184 <br /> : LOT 102 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2500 ESCROW IS TIED TO DEMO PERMIT 2017-01453 PAID BY ANDERSON REDA CHECK#25212 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> ANDERSON REDA Payment(s) <br /> 4920 LINCOLN DRIVE CHECK 25212 2,500.00 <br /> EDINA,MN 55435- <br /> OWNER <br /> HEMSLEY,MATT <br /> 4620 MOORLAND AVE <br /> EDINA,MN 55435- <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 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br />