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CITY OF ORONO * 2012 - 01115 * <br /> - - 2750 KELLEY PARKWAY DATE ISSUED: 1VOV2012 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> REPRINTED ON 11/1/2012 <br /> ADDRESS : 2645 WATERTOWN RD <br /> PIN : 04-117-23-12-0008 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE ESCROW FEE-WETLAND <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ESCROW FEE-WETLAND <br /> NOTE: THIS$3,000 WETLAND BUFFER ESCROW IS TIED TO PERMIT 2012-01026. <br /> APPLICANT ESCROW FEE-WETLAND 3,000.00 <br /> VANOVERBEKE,PETER&AMANDA TOTAL 3,000.00 <br /> 2645 WATERTOWN RD <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> VANOVERBEKE,PETER&AMANDA <br /> 2645 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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />