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' ' � CITY OF ORONO * 2 0 1 6 - PJ 0 5 1 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/12/2016 <br /> ORONO,MN 55356- <br /> � (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4215 NORTH SHORE DR <br /> PIN : 07-117-23-43-0006 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMTT TYPE : ESCROW FEE-TIED TO BUII.,DING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUII,DING PERMIT <br /> NOT'E: ESCROW FOR BUII.DIl�G PERMIT#2016-00351 FOR DECK-PD BY:OWNERS WALDOCH'S-CK#12141-$700.00 <br /> APPLICANT ESCROW FEE-BUII..DING 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 /> MOLTND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> 'I'he 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 addirional 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 /> eacpire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construcrion is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> 'I'he 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. G <br /> 5�l �� l�.—�--e---f�c� 5 � I� / <br /> �.� S� - <br /> Applicant Permitee Signature Date Issued By Signature Date <br />