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CITY OF ORONO PERMIT NO.: 2010-00377 <br /> ' 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- �ATE ISSUED: OS/24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2172 SHADYWOOD RD <br /> PIIv : 17-117-23-42-0010 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 000 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 TIED TO DEMO PERMIT 2010-00376 <br /> BUILDING PERMIT 2010-00336 `;�`' '�.',:c'1 :-`,ir'h.�d3'i i <br /> i;�nr� pMN�ii SS3�� SS2—�4�--4bf� ; <br /> i <br /> �'�:E°A�11 �J: ,`..�)Qc.'tr1.S�� �sj� �:!i.� ?�i�� 1 <br /> I <br /> >,rt �. h6t"e i <br /> i <br /> i;iY1Q ei� L�t�fi;P1� <br /> �:,1�-i;��377 �1 i� 5'F�aclya+c�sd �:,SCO,tk"t � <br /> , <br /> ��a � <br /> . � <br /> ':%1•'��.�C:'�'(!J i <br /> ;r,�rr�d r,ev-I1�velc,.�er �e�c�sii� <br /> ___.--�-- - .._ I <br /> "c,ta 1: t.-,54t7.{�j � <br /> n�ci! .__—-_ _-.__ i <br /> Ut'Fec�, ��. T .�3,.`r �'.,`�tri�.�:'� <br /> ��yfil': . i <br /> :it84�71 �i. �h`f! <br /> .,�3i A,�U`'!+.�: ?,:�s±tr' ;K� <br /> APPLICANT ESCROW FEE-BU[LDING 2,500.00 <br /> DORE, STEVEN TOTAL 2,500.00 <br /> 835] WEST 109TH STREET <br /> BLOOMINGTON, MN 55438- <br /> (952)358-3303 <br /> OWNER <br /> DORE, STEVEN <br /> 8351 WEST 109TH STREET <br /> BLOOMINGTON, MN 55438- <br /> AGREEMENT AIYD 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 /> S[ate 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 any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />