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' CITY OF ORONO * 2 0 1 6 - P1 1 5 6 4 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 940 NORTH ARM DR <br /> PIN : 07-117-23-11-0014 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTTON TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR TEMPORARY CERTIFICATE OF OCCUPANCY- BU[LDING PERM[T#2016-00533 -PAID BY:OWNER:ROMAN <br /> OLSHANSKY-CK#9002-$7,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 7,500.00 <br /> OLSHANSKY,ROMAN TOTAL 7,500.00 <br /> Payment(s) <br /> 76 KINGSVIEW LANE N CHECK 9002 7,500.00 <br /> PLYMOUTH,MN 5544�- <br /> OWNER <br /> OLSHANSKY, ROMAN <br /> 76 KINGSVIEW LANE N <br /> PLYMOUTH, MN 55447- <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. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this rype 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 I80 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 time for due cause. � <br /> �L �_� <br /> � �.� � C��.l_ � �������� 1�E=,;� �` � ` `�/ �� <br /> Applicant Permitee Si nat re Date Issued By Signature Date <br />