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CITY OF ORONO , !l 1' 1 . � I' <br /> * 2015 - 011499 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/23/2015 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 420 ORCHARD PARK RD <br /> PIN : 32-118-23-23-0006 <br /> LEGAL DESC : ORCHARD PARK <br /> : LOT 008 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: ESCROW FOR SHED PERMIT#2015-01481-PAID BY:WILLIAM&LYNAE PETERSON-CK#14831-$700.00 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> PETERSON,WILLIAM&LYNAE Payment(s) <br /> 420 ORCHARD PARK RD CHECK 14831 700.00 <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> PETERSON,WILLIAM&LYNAE <br /> 420 ORCHARD PARK RD <br /> LONG LAKE,MN 55356- <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 ime for due se n <br /> / <br /> l i_ '�J (/ GL P• , to•�--,-rsv / ( 2.3/ 7c <br /> Ap;;rc. •ermitee Signature Date Issued By Si ture Date <br />