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CITY OF ORONO * 2 0 1 5 — PJ 1 3 5 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/28/2015 <br /> • t ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4195 HIGHWOOD RD <br /> PIN : 07-117-23-44-0095 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(501+CU YDS) <br /> NOTE: PRIOR TO RELEASE OF ESCROW MONEY AN AS BUILT SURVEY MUST BE SUBMITTED AND APPROVED. INITIAL: <br /> APPLICANT MAJOR LAND ALTERATION 50.00 <br /> ENGINEERING REVIEW COSTS <br /> CONCEPT LANDSCAPING TOTAL 50.00 <br /> 3153 PRIEST LANE <br /> MOiJND,MN 55364 Payment(s) <br /> 0 CHECK 36920 50.00 <br /> OWNER <br /> SMITH,DOUGLAS&ROBAN <br /> 4195 HIGHWOOD RD <br /> MOLJND,MN 55364 <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. 1'his 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 goveming this 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 180 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any ti e cause. <br /> � <br /> d � I(7i2�i1� <br /> Applicant P itee Signature Date Issued B S ature Date <br />