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� <br /> � � CITY OF ORONO * Z 0 1 5 - 0 1 0 4 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08J17/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2060 SIXTH AVE N <br /> PIN : 27-118-23-31-0002 <br /> LEGAL DESC : UNPLATTED 27 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RELIGIOUS <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$700 ESCROW IS TIED TO VARIANCE APPLICATION 15-3779 <br /> APPLICANT ESCROW FEE-APPLICANT 700.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> CHURCH,TRINTY LUTHERAN TOTAL 700.00 <br /> 2060 SIXTH AVE N Payment(s) <br /> LONG LAKE,MN 55356- CHECK 24432 700.00 <br /> OWNER <br /> CHURCH,TRINTY LUTHERAN <br /> 2060 SIXTH AVE N <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 ffiis 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 I80 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 aze <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 />