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* CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 1S - 01 <br /> 5 8 <br /> DAT0 E ISSUED: 08/11 9/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2185 WATERTOWN RD <br /> PIN : 03-117-23-21-0004 <br /> LEGAL DESC : UNPLATTED 03 117 23 <br /> LOT 000 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 15-3782 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL 2,500.00 <br /> OTTO,STEPHEN Payment(s) <br /> 2185 WATERTOWN RD CHECK 4763 2,500.00 <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> OTTO,STEPHEN <br /> 2185 WATERTOWN RD <br /> LONG LAKE,MN 55356- <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 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 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 /> Applicant Permitee Signature Date Issued By Signature Date <br />