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CITY OF ORONO PERMIT NO.: 2011-00977 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 08/31/2011 <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 840 OLD CRYSTAL BAY RD S <br /> PIN : 09-117-23-12-0002 <br /> LEGAL DESC : UNPLATTED 09 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2,000.00 ESCROW IS TIED TO DEMO PERMIT#2011-00947 <br /> APPLICANT ESCROW FEE-BUILDING 2,000.00 <br /> CHARLES CUDD LLC TOTAL 2,000.00 <br /> 15050 23RD AVENUE N <br /> PLYMOUTH,MN 55447-0 City of Orono <br /> 2750 Kelley Parkway <br /> Minnesota State License#:20635245 Orono /1141 55356 952-249-4600 <br /> Receipt No: 3.005366 Aug 31, 2011 <br /> OWNER <br /> WILLIAMS,JAMES&HEIDI <br /> 2011-00947 / 840 MB Rd N <br /> 840 OLD CRYSTAL BAY RD S <br /> WAYZATA,MN 55391- Previous Balance: .00 <br /> Permits <br /> Escrow - Demo 2,000.00 <br /> 101-22205 <br /> AGREEMENT AND SWORN STATEMENT Deferred Rev-Developer Deposit <br /> - <br /> The work for which this permit is issued shall be performed according to Total: 2.000.00 <br /> the approved plans and specifications,applicable City approvals,and the New Balance: 2,000.00- <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 Check <br /> permits. All provisions of laws and ordinances governing this type of work Check No: 021871 2,000.00 <br /> shall be compied with whether or not specified herein.This permit will Payor: <br /> expire and become null and void if construction authorized is not 2011-00947 / 840 DCB Rd N <br /> commenced within 180 days of the date of issuance,or if construction is Total Applied: 2,000.00 <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 Change Tendered: .00 <br /> requested in conformance with the State Building Code.This permit may be 08/31/2011 03:04Pbf <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 />