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CITY OF ORONO * Z 0 1 3 - 0 0 9 6 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/16/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2605 LYDIARD CIR <br /> PIN : 20-117-23-14-0001 <br /> LEGAL DESC : APPLE HILL <br /> : LOT 003 BLOCK OOl <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 BUILDING PERMIT-#2013-00831-PD CHECK#7927 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> LERVIK,GARY MALTZEN&BONNIE ESCROW FEE-EROSION CONTROL 0.00 <br /> 2605 LYDIARD CIR <br /> EXCELSIOR,MN 55331- ESCROW FEE-GRADING 0.00 <br /> TOTAL 2,500.00 <br /> OWNER <br /> LERVIK, GARY MALTZEN&BONNIE <br /> 2605 LYDIARD CIR <br /> EXCELSIOR,MN 55331- <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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied wi[h 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 1 SO days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <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 />