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• <br /> CITY OF ORONO <br /> 11 I III <br /> * 2014 - 01449 *4 <br /> 2750 KELLEY PARKWAY <br /> DATE ISSUED: 12/19/2014 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 450 OLD LONG LAKE RD <br /> PIN : 36-118-23-34-0014 <br /> LEGAL DESC : SUMMIT STATION <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR BUILDING PERMIT#2014-01376-PD CK#15649 BY SCHWARZ BUILDERS <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> SCHWARZ BUILDERS INC. TOTAL 2,500.00 <br /> Payment(s) <br /> 240 MINNETONKA AVE S, SUITE 2 CHECK 15649 2,500.00 <br /> WAYZATA,MN 55391 <br /> (952)476-6768 <br /> Minnesota State License#:BUIL-BC003922 <br /> OWNER <br /> POLICINSKI,CHRISTOPHER&ANNE <br /> 450 OLD LONG LAKE 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 as uri :all required inspections are <br /> requested in conform.. ce with t S :t,Buil g Code.This permit may be <br /> revoked at any ti f• • e catr, <br /> �. <br /> 9 yLie �� 79/ <br /> Applicant 'ermitee Sign. re Date Issued By Signature Date <br />