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� ` CITY OF ORONO <br /> * Z 0 1 3 - 0 0 5 2 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/19/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1850 FOX RIDGE RD <br /> PIN : 03-117-23-13-0008 <br /> LEGAL DESC : FOX RIDGE <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING PERM['I' 13-3611-PD CK#t3366-I3Y MARK SANDERSON <br /> APPLICAI�T ESCROW FEE-APPLICANT 2,500.00 <br /> STEPHENSON III ET AL, REVIS L ESCROW FEE- DEVELOPER 0.00 <br /> 1850 FOX RIDGE RD <br /> LONG LAKE, MN 55356- TOTAL 2,500.00 <br /> OWNER <br /> STEPHENSON III ET AL, REVIS L <br /> 1850 FOX RIDGE RD <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> "rhe work for which this permit is issucd shall bc performed according to <br /> the approved plans and specitications,applicable City approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for addi[ional 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 specitied 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 1 SO 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 />