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� CITY OF ORONO * 2 0 1 5 - 0 1 1 2 5 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 09/03/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 880 PARTENWOOD RD <br /> PIIv : OS-117-23-43-0001 <br /> LEGAL DESC : PARTENWOOD <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW TIED TO ZONING PERMIT FOR DRIVEWAY-PERMIT#2015-01010-PAID BY:JERRY&CINDY GRAY-CK#5543- <br /> $2,000.00 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> TOTAL 2,000.00 <br /> GRAY,JERRY&CYNTHIA Payment(s) <br /> 880 PARTENWOOD RD CHECK 5543 2,000.00 <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> GRAY,JERRY&CYNTHIA <br /> 880 PARTENWOOD 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 dces <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 conswction 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 a[any time after work has commenced. <br /> The applicant is responsible for assuring aIl 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 /> _ , J�� r �.�:s.t, <br /> � � i3i � <br /> Applic t Permitee Signature ate Issued By Signature Date <br />