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CITY OF ORONO * 2 0 1 6 - 0 0 0 7 6 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/21/2016 <br /> ORONO,MN 5356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 425 OLD CRYSTAL BAY RD N <br /> PIN 33-118-23-24-0003 <br /> LEGAL DESC UNPLATTED 33 118 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE ESCROW FEE-APPLICANT <br /> PROPERTY TYPE OTHER <br /> CONSTRUCTION TYPE ESCROW FEE-APPLICANT <br /> NOTE: THIS$10,000 ESCROW IS TIED TO SUBDIVISION APPLICATION 16-3807 <br /> THIS INCLUDES 425&595 OLD CRYSTAL BAY ROAD N AND UNASSIGNED <br /> PID'S 33-118-23-24-0001 AND 33-118-23-24-0002 AND 33-118-23-24-0003 <br /> APPLICANT ESCRO FEE-DEVELOPER 10,000.00 <br /> TOTAL 10,000.00 <br /> ESTATE DEVELOPMNET CORPORATION Payment(s) <br /> 15250 WAYZATA BLVD, SUITE 101 CHECK 5399 10,000.00 <br /> WAYZATA,MN 55391- <br /> (612)990-0666 <br /> OWNER <br /> FREDERIKSEN,SCOTT T <br /> 4350 BAKER RD,SUITE#400 <br /> MINNETONKA,MN 55343- <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 />