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� <br /> '" CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 7 - 0 1 1 7 2 * <br /> DATE ISSUED: 09/2 U2017 <br /> ORONO,MN 55356- <br /> (952 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1720 SHADYWOOD RD <br /> PIN : 17-117-23-21-0019 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$1,000 ESCROW IS TIED TO ZONING PERMIT APPLICATION 17-3978 PAID BY ALEXANDER DESIGN GROUP WITH <br /> CHECK# 10692 <br /> APPLICANT ESCROW FEE-APPLICANT 1,000.00 <br /> HANSBERGER,TRAVIS TOTAL 1,000.00 <br /> 651 LEXIE CT Payment(s) <br /> EAGAN,MN 55123- CHECK 10962 1,000.00 <br /> OWNER <br /> HANSBERGER,TRAVIS <br /> 651 LEXIE CT <br /> EAGAN,MN 55123- <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 dces <br /> not grant permission for additional or related work which requ'ves separate <br /> permits. All provisions of laws and ordinances governing 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 rime after work has commenced. <br /> The applicant is responsible for assuring a11 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 /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />