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s r .. . <br /> CITY OF ORONO * 2 0 1 7 — PJ 1 PJ 4 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/31/2017 <br /> � ORONO,NIN 5535Cr <br /> (952)249-4600 FAX: (952 249-4616 <br /> ADDRESS : 4240 NORTH SHORE DR <br /> PIN : 07-117-23-43-0014 <br /> LEGAL DESC : SAGA HII.,L REVISED <br /> : LOT 000 BLOCK 014 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERNIIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$700 ESCROW IS'TIED TO BUII.,DING PERMIT 2017-01029 PAID BY PETER SCHWARZKOPF CHECK#1096 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> SCHWARZKOPF,PET'ER&JENNIFER Payment(s) <br /> 4240 NORTH SHORE DR CHECK 1096 700.00 <br /> MOUND,MN 55364 <br /> OWNER <br /> SCHWARZKOPF,PETER&JENNIFER <br /> 4240 NORTH SHORE DR <br /> MOUND,NIN 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 permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepatate <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 1 SO 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 /> The applicant is responsible for assuring all required inspecrions are <br /> requested in conformaace 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 />