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. � <br /> CITY OF ORONO * Z 0 1 3 - 0 0 4 9 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/13/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2100 SHADYWOOD RD <br /> PIN : 17-117-23-31-0041 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 030 BLOCK 001 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION (0-500 CU YDS) <br /> NOTE: �2,000 S/B COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2000.00 <br /> HOW DID THEY PAY? CHECK#5132& WHO PAID? STEVEN HICKS <br /> ESCROW PERMIT#:(DON'T FORGET"I'O ENTER) 2013-00494 <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS <br /> APPL[CANT MINOR LAND ALTERATION 50.00 <br /> CONCRETE SCIENCE SERVICES ENGINEERING REVIEW COSTS <br /> 7545 COMMERCE ST. WEST <br /> CORCORAN, MN 55340- TOTAL 50.00 <br /> (612)616-7323 <br /> OWNER <br /> MARHULA, DAREN <br /> 2100 SHADYWOOD 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 da[e 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 /> re k�at�ny time for due cause. <br /> %� (e / l3 / �� �/ /v� ll� <br /> iApplicant Per rtee Signature Date ]ss d By Signature Date <br /> �--- SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />