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CITY OF ORONO � 0 1 3 - 0 PJ B 7 4 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 08/27/2013 <br /> � ORONO, MN 55356- <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3165 NORTH SHORE DR <br /> PIN : 09-117-23-33-0002 <br /> LEGAL DESC : UNPLATTED 09 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(501+CU YDS) <br /> NOTE: $AMOUNT TO BE DETERMINED BY CUP-SB COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $5000 <br /> HOW DID THEY PAY? WAGENER PROPERTIES LLC <br /> ESCROW PERMIT#:(DON'T FORGET TO ENTER) 2013- <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS <br /> APPLICANT MAJOR LAND ALTERATION 50.00 <br /> Wagener Properties LLC ENGINEERING REVIEW COSTS <br /> 12520 WAYZATA BLVD <br /> MINNETONKA, MN 55305- TOTAL 50.00 <br /> OWNER <br /> Wagener Properties LLC <br /> 12520 WAYZATA BLVD <br /> MINNETONKA,MN 55305- <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 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 /> r ked at any time for due cause. <br /> (�/ 17��/ � / / <br /> pplicant Permitee Signature Date Issued y S' ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A <br />