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liiiiiiiiiiiiiiiiiiiiillillillillillillilliillim <br /> CITY OF ORONO * 2013 - 00087 * <br /> 190 2750 KELLEY PARKWAY DATE ISSUED: 02/04/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4725 NORTH SHORE DR <br /> PIN : 07-117-23-32-0066 <br /> LEGAL DESC : BERGQUIST&WICKLUNDS PARK <br /> LOT MB BLOCK 5 <br /> PERMIT TYPE ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE RESIDENTIAL Cit of Orono <br /> CONSTRUCTION TYPE ESCROW FEE-TIED TO BUILDING PERMIT 275 Kelley Parkway <br /> Orono hid 55356 952-2494600 <br /> NOTE: ESCROW PAID BY JOHN ROEDEL-CK#7370 Receipt No: 3.008388 Feb 4, 2013 <br /> John Roedel <br /> Planninq and Zoninq <br /> Escrow deposit - 4725 2,000.00 <br /> Forth Shore Dr <br /> 101-22205 <br /> Deferred Rev-Developer Deposit <br /> Total: 29000.00 <br /> Check <br /> Check No: 7370 21000.00 <br /> Pavor: <br /> John Roedel <br /> Total Applied: 2,000,00 <br /> Change Tendered: .00 <br /> 02/04/2013 08:15AN <br /> APPLICANT ESCROW FEE-BUILDING 2,000.00 <br /> ROEDEL,JOHN TOTAL 2,000.00 <br /> 4725 NORTH SHORE DRIVE <br /> MOUND,MN 55364- <br /> OWNER <br /> ROEDEL,JOHN <br /> 4725 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 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 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 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 /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />