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CITY OF ORONO �0 1 3 - P1 1 2 9 B * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/16/2013 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 4395 NORTH SHORE DR <br /> PIN : 07-117-23-43-0018 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK 018 <br /> PERMIT TYPE : ESCROW FEE-OTHER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-OTHER <br /> NOTE: THIS$7500.00 ESCROW IS FOR A TEMPORARY CERTIFICATE OF OCCUPANCY <br /> APPLICANT ESCROW FEE-OTHER 7,500.00 <br /> TOTAL 7,500.00 <br /> CORNESS,JOHN&BARBARA Payment(s) <br /> 4395 NORTH SHORE DR CHECK 2238 7,500.00 <br /> MOiJND,MN 55364- <br /> OWNER <br /> CORNESS,JOHN&BARBARA � <br /> 4395 NORTH SHORE DR <br /> MOLTND,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. This permit is for only the work described and does <br /> not gran[permission for additional or related work which requires sepazate <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.1'his permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />