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CITY OF ORONO iiiiiiiiiiiiiiiiiiiiiillillillillillillilliiiim <br /> 2750 KELLEY PARKWAY * 2 12 - 0 <br /> 1 7 <br /> DAT0 E ISSUED:: 10/11 6/22 012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> REPRINTED ON 10/18/2012 <br /> ADDRESS : 4731 NORTH SHORE DR <br /> PIN : 07-117-23-32-0067 <br /> LEGAL DESC : BERGQUIST&WICKLUNDS PARK <br /> : LOT MB BLOCK 5 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING PERMIT- 12-3582-PD CH#7544 BY COLSON CUTOM HOMES <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> COLSON CUSTOM HOMES TOTAL 2,500.00 <br /> 18001 HIGHWAY 7 <br /> MINNETONKA,MN 55345- <br /> Minnesota State License#:20276966 <br /> OWNER <br /> BWB Holdings LLC <br /> 3800 AMERICAN BLVD W#100 <br /> BLOOMINGTON,MN 55431- <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 />