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� � CITY OF ORONO * z 0 1 4 - 0 0 5 1 � <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/29/2014 <br /> ' ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3860 NORTH SHORE DR <br /> PIN : 08-117-23-33-0095 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 000 BLOCK 007 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> NOTE: $2,000 SB COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000.00 <br /> HOW DID THEY PAY? CHECK#869 PAID BY BRETT SIMMONS <br /> NOTE: FINAL INSPECTINO MUST BE COMPLETED PRIOR TO RELEASE OF ESCROW FUNDS. �INITIAL <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> ENGINEERING REVIEW COSTS <br /> SIMMONS,BRETT <br /> 3860 NORTH SHORE DRIVE TOTAL 50.00 <br /> MOUND,MN 55364- Payment(s) <br /> CHECK 869 50.00 <br /> OWNER <br /> SIMMONS,BRETT <br /> 3860 NORTH SHORE DRIVE <br /> MOUND,MN 55364 <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 pertnit 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 goveming this type of work <br /> shall be compied with whether or not specified hercia 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 /> �' ���, �Y <br /> A e�can�t F�ermrtee Si nature Date (� /��/ / <br /> PP g Issue By Signature Date <br />