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CITY OF ORONO * 2 0 1 5 - 0 0 1 6 5 * <br /> ' � 2750 KELLEY PARKWAY DATE ISSUED: 02/09/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3655 NORTH SHORE DR <br /> PIN : 08-117-23-34-0050 <br /> LEGAL DESC : CRYSTAL BEACH <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$7500 ESCROW IS TIED TO BUILDING PERMIT#201400603 FOR A TEMPORARY CERTIFICATE OF OCCUPANCY <br /> APPLICANT ESCROW FEE-APPLICANT 7,500.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> HAGEN,AL&DONNA TOTAL 7,500.00 <br /> 3655 NORTH SHORE DR Payment(s) <br /> WAYZATA,MN 55391- CHECK 5028 7,500.00 <br /> OWNER <br /> HAGEN,AL&DONNA <br /> 3655 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 Building Code. This permit is for only the work described and does <br /> no[grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shali 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 ail 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 />