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+ ' ' CITY OF ORONOIH I' iI �' � �' 11 <br /> * <br /> 2750 KELLEY PARKWAY * 20 1 4 - 00 1 3 0 <br /> DATE ISSUED: 02/12/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 20 ORONO ORCHARD RD N <br /> PIN 35-118-23-33-0009 <br /> LEGAL DESC : ORONO OAKS <br /> : LOT 013 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: TIED TO DEMOLITION PERMIT 2014-00107 <br /> APPLI ANT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> NIH HOMES Payment(s) <br /> 6840 213TH AVENUE CHECK 21191 2,500.00 <br /> ELK RIVER,MN 55330- <br /> (763)753-1750 <br /> Minnesota State License#:BU1L,-BC419931 <br /> OWNER <br /> Old Orchard Farm,LLC <br /> 30 ORONO ORCHARD 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 coristruction authorized is not <br /> commenced within 180 days of the da of issuance,or if construction is <br /> suspended for a period of 180 days at y time after work has commenced. <br /> The applicant is responsible for assuri g all required inspections are <br /> requested in conformance with the St e Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br />