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A # CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 16 - 01 1 4 <br /> DAT0 E ISSUED: 10/11 7/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)2494616 <br /> ADDRESS : 2560 OLD BEACH RD <br /> PIN 21-117-23-22-0010 <br /> LEGAL DESC : SHORE HILLS <br /> LOT 025 BLOCK 000 <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 2016-01313 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> KREY,JAMES Payment(s) <br /> 2560 OLD BEACH RD CHECK 7055 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> KREY,JAMES <br /> 2560 OLD BEACH RD <br /> WAYZATA,MN 55391- <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 />