Laserfiche WebLink
� ' CITY OF 0120N0 * 2 0 1 6 - 0 1 1 7 2 * <br /> 2750 KELLEY P WAY DATE ISSUED: 09/22/2016 <br /> ORONO,MN 55356- <br /> ' (952)249-4600 FAX: (952) 249-4616 <br /> , <br /> ADDRESS : 1750 SHADYWOOD RD <br /> PIN : 17-117-23-21-0021 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 016 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING APPLICATION 16-3874 <br /> APPLICANT ESCRIOW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> SHAW,GRETCHEN Paym nt(s) <br /> 1750 SHADYWOOD RD CHE(�K 10379 2,500.00 <br /> WAYZATA,MN 55391- i <br /> � <br /> OWNER i <br /> SHAW,GRETCHEN <br /> 1750 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> � <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 fior only the work described and does I <br /> not grant permission for additional or related work which requires separate <br /> permiu. AII provisions of laws and adinances 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 /> revoked at any time for due cause. ' <br /> I <br /> / / <br /> Applicant Permitee Signature Date Issudd By Signature Date <br />