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f <br /> CITY OF ORONO * 2017 - 00932 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/08/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)2494616 <br /> ADDRESS : 3065 WATERTOWN RD <br /> PIN : 04-117-23-22-0033 <br /> LEGAL DESC : WALNUT CREEK <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$700 ESCROW IS TIED TO BUILDING PERMIT 2017-00932 PAID BY THOMAS CONSTRUCTION CHECK#3149 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> THOMAS CONSTRUCTION&REMODELING Payment(s) <br /> 5443 RIVER WOOD DRIVE CHECK 3149 700.00 <br /> SAVAGE,MN 55378- <br /> (651)263-7680 <br /> Minnesota State License#:BUIL-BC20635978 <br /> OWNER <br /> DAHL,JEFFREY&LOIS <br /> 3065 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 />