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. CITY OF ORONO * Z 0 1 6 - 0 0 5 1 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/12/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4215 NORTH SHORE DR <br /> PI(V : 07-117-23-43-0006 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BU[LDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR BUILDING PERMIT#2016-00351 FOR DECK-PD BY:OWNERS WALDOCH'S-CK#12141 -$700.00 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> WALDOCH, DOUGLAS&DIANE Payment(s) <br /> 4215 NORTH SHORE DR CHECK 12141 700.00 <br /> MOUND,MN 55364- <br /> OWNER <br /> WALDOCH,DOUGLAS&DIANE <br /> 4215 NORTH SHORE DR <br /> MOUND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> Ihe 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 goveming 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 /> � � c � ���, � �u � J��—f-�� , �� � <br /> 1�1� �l� l�� � � � / L <br /> Applicant errnitee Signature Date � � Issued By Signat e Date <br />