HomeMy WebLinkAbout2010-01143 - escrow fee CITY OF ORONO PERMIT NO.: 2oiaoiia3
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IsstlEn: 1U19/2010
952 249-4600 FAX: 952 249-4616
REPRINTED ON 1/13/2011
� ADDRESS : 3095 NORTH SHORE DR
i PIN : 09-117-23-32-0014
LEGAL DESC : REG.LAND SURVEY NO. 0670
: LOT 000 BLOCK 000
PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT
NOTE: ESCROW OF$2,000 TIED TO DEMO PERMIT#2010-01141-PAID BY:OWNER,MICHAEL&PAMELA SIME VIA CK#7132 ON
11/19/10
APPLICANT ESCROW FEE-BUILDING 2,000.00
SIME, MICHAEL& PAMELA TOTAL 2,000.00
1592 MED[NA RD
LONG LAKE, MN 55356-
OWNER
' SIME,MICHAEL&PAMELA
1592 MEDINA RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed 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 sepazate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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� ,Applicant Permitee Signature Date Issued By Signature Date
� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.