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' ' ,� CITY OF ORONO * 2 0 1 5 - 0 1 5 9 0 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 12/23/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1025 SPRING HILL RD <br /> PIN : 26-118-23-43-0005 <br /> LEGAL DESC : UNPLATTED 26 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: ESCROW AGREEMENT FOR SEPTIC SYSTEM TIED TO NEW HOME#2015-01444-PAID BY OWNERS:JOHN&CYNDY <br /> BOWLSBY-CK#12660-$15,000.00. AGREEMENT GIVEN TO JEREMY IN PLANNING. <br /> APPLICANT ESCROW FEE-APPLICANT 15,000.00 <br /> TOTAL 15,000.00 <br /> BOWLSBY,JOHN&CYNDY Payment(s) <br /> 1025 SPRING HILL ROAD CHECK 12660 15,000.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> BOWLSBY,JOHN&CYNDY <br /> 1025 SPRING HILL ROAD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORl�1 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 dces <br /> not grant permission for additional or related work which requires 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 time after work has commenced. <br /> The applicant is responsible for asswing 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 /> � <br /> {�C�� ��-IX��S U IZ 2 3 / � S <br /> Applicant Permitee Signature Date Issued By Signature Date <br />