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' ' � CITY OF ORONO * 2 0 1 3 - P1 1 1 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/3ll2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> REPRINTED ON l0/31/2013 <br /> ADDRESS : 2690 CAROLINE AVE <br /> PIN : 20-117-23-24-003 3 <br /> LEGAL DESC : WESSELS SUBD OF SPRING PARK LO <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$2500 ESCROW IS TIED TO LAND USE APPLICATION#13-3642,BUILDING PERMIT#20 1 3-0 1 052 AND <br /> DEMO PERMIT#2013-00959 -PD CHECK#12039 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> LIBERMAN,ZIV&TAL ESCROW FEE-EROSION CONTROL 0.00 <br /> 1145 SETTLERS ROAD <br /> MEDINA,MN 55340- ESCROW FEE-GRADING 0.00 <br /> TOTAL 2,500.00 <br /> C�i�ty af Orono ; <br /> 2750 Kelley Parkrwy <br /> Orono Mi 5535b 952-249-#b40 � <br /> OWNER <br /> LIBERMAN,ZN&TAL �ipt No: 3.0100�6 Oct 31, 2U13 <br /> 1145 SETTLERS ROAD <br /> MEDINA, MN 55340- Ziv Liber�an <br /> Planoing end Ioning <br /> 20�13-OlIbS �b90 Caroline 2,500.OQ <br /> AGREEMENT AND SWORN STATEMENT 101-2�''c4S <br /> The work for which this permit is issued shall be performed according to Deferred Re�-peyeloper Deposit <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 TOtdl: 2��,(� <br /> not grant permission for additional or related work which requires sepazate ' <br /> permits. All provisions of laws and ordinances goveming this type of work �k <br /> shall be compied with whether or not specified herein.This permit will {�12Ck I�p; lt�j� ��SQQ�(Xj ' <br /> expire and become null and void if conswction authorized is not pB�OT': <br /> commenced within 180 days of the date of issuance,or if construction is ZlY �1� <br /> suspended for a period of 180 days at any time afrer work has commenced. Tat81 APpI12d: ��,0(j <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be Char►ge TenderedC ,Q(j <br /> revoked at any time for due cause. 1O/3�/�II�3 iP:13PM1 ' <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />