HomeMy WebLinkAbout2011-01233 (escrow fee) � • CITY OF ORONO rERMiT rro.: 2011-01233
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE 1ssvED: 10/12/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3510 BAYSIDE RD
PIN : OS-117-23-13-0016
LEGAL DESC : AUDITOR'S SUBD.NO.203
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: TIED TO BUILDING PERMIT 2011-01182 SWIMMING POOL
PD BY GREGG LARSEN CK 2187 10/12/1 1
APPLICANT ESCROW FEE-BUILDING 2,500.00
LARSEN, GREGG& STEPHANIE
3510 BAYSIDE RD TOTAL 2,500.00
LONG LAKE, MN 55356-
OWNER
LARSEN, GREGG & STEPHANIE
35]0 BAYSIDE RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
Thc work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Buiiding Code. This permit is for only the worh described and does
not grant permission for additional or rela[ed work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shail be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
cequested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date lssued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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File Tran�a�_tion Rep�-�rt:
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General � Fee� Inspections(3} ���4tes � Applicairt Detail � CO De#ail � '
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Checklist for Refunding Building Permit Escrows
Building Permit # ��� � 0 �� �Z-
Street Address: ��� � ��
Applicant Name: �I� �--
� Escrow request received Date: IL �� " ��
Permit Type: �6d'
Are all inspections completed? es No
If not, list what is outstanding:
Was there a Temporary Certificate of Occupancy issued? Yes � Date:
Was there a Final Certificate of Occupancy issued? Yes � Date:
As-built survey required? Yes, approved on �� �,��'� � NO NA
C� Email CK & Bonestroo to see if there is any unbilled WIP. Date email sent: � 2~ � � � �
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❑ Prepare memo for Finance Department �� �'�`� �� �
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z:\forms�zoning standard forms\checklist for refunding buitding permit escrows.doc
LastUpdated: 10-31-2011