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� • � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 5 — 0 0 9 2 2 * <br /> DATE ISSUED: 07/23/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 60 SMITH AVE <br /> PIN : 02-117-23-21-0003 <br /> LEGAL DESC : ORONO ORCHARDS <br /> : LOT 041 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 VARIANCE APPLICATION#15-3772 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> MILLER,ROBERT Payment(s) <br /> 60 SMITH AVE CHECK 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> MILLER,ROBERT <br /> 60 SMITH AVE <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he 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 dces <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of►aws 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 /> 1'he applicant is responsible for assuring all required inspections are <br /> requested in conforrr►ance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> A.pplicant Permitee Signature Date Issued By Signature Date <br />