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CITY OF ORONO * 2 0 1 3 - 0 1 2 9 8 * <br /> ' ' ' 2750 KELLEY PARKWAY DATE ISSUED: 1?Ji6/2013 <br /> ORONO,NIN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4395 NORTH SHORE DR <br /> PIN - : 07-117-23-43-0018 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK U18 <br /> PERMIT TYPE : ESCROW FEE-OTI�R� <br /> PROPERTY TYPE : RESIDENTIAL • <br /> CONSTRUCTION TYPE : ESCROW FEE-OTI�R <br /> NOTE: T'HIS$7500.00 ESCROW IS FOR A TEMPORARY CERTIFICATE OF OCCUPANCY <br /> APPLICANT ESCROW FEE-OTHER 7,500.00 <br /> TOTAL 7,500.00 <br /> CORNESS,JOHN&BARBARA Payment(s) <br /> 4395 NORTH SHORE DR CHECK 2238 7,500.00 <br /> MOUND,MN 55364- <br /> ' C�ity,of Or� <br /> Z7�1 Kelley Park�y <br /> OWNER �� � � �''�� <br /> CORNESS,JOHN&BARBARA �eipt Rb: 3.O1f1�05 1kc lb, 2013 <br /> 4395 NORTH SHORE DR f <br /> MOiJND,MN 55364 43�i �6 Drive #�{?13-00317 <br /> Plan�i ar� Toni <br /> a <br /> � Esrrow it - T 7,�.00 <br /> 101-2'�2Q5 <br /> AGREEMENT AND 5WORN STATEMENT Defc�ed �v�ievelv�er �posit <br /> The work for which this permit is issued shall be performed according to T4tdl: 7�5�.� <br /> the approved plans and specifications,applicable City approvals,and the j <br /> State Building Code. This permit is for only the work described and does �tE�it <br /> not grant permission for additional or related work which requires separate C�IEC'k �C �3$ 7��i.Q� ' <br /> permits. All provisions of laws and ordinances goveming this type of work 4�� ]�p,lY2 #�013-00317 <br /> shall be compied with whether or not specified herein.l7vs permit will <br /> expire and become null and void if construction authorized is not Total Appia�: 7�SflO.� <br /> commenced within 1 SO 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. �1diT�E T�2Pe�: .� <br /> The applicant is responsible for assuring all required inspections are 12/16/�1113 �?3!1� <br /> requested in conformance with the State Building Code.This pemvt may be <br /> revoked et any time for due cause. <br /> / / <br /> Apphcant Permitee Signature Date Issued By Signature Date <br />