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Home My WebLink About2009-00636 - escrow fee CITY OF ORONO PERMIT NO.: 2009-00636 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEu: 09/25/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 965 EDGEWOOD HILLS RD PIN : 02-117-23-14-0001 LEGAL DESC : REG. LAND SURVEY NO. 1098 : LOT 000 BLOCK 000 PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT NO"I�E: THIS F,SCROW PAYMENT IS TIED TO BUILDING PERMIT#2009-00635 APPLICANT ESCROW FEE- BUILDING 2,500.00 CUSICK, MR. & MRS. THOMAS ESCROW FEE- EROSION CONTROL 0.00 965 EDGEWOOD HILLS RD WAYZATA, MN 55391 ESCROW FEE-GRADING 0.00 Minnesota State License#: 4290 TOTAL 2,500.00 OWNER CUSICK, MR. & MRS. THOMAS 965 EDGEWOOD HILLS RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfonned according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expirc and become null and void if construetion 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 requested in conformance with the Sta[e Building Code.This permit may be revoked at any time for due cause. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.