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CITY OF ORONO I I 11 I 11 I I III III I I1I I III II I <br /> * 20 1 6 - 0 1 060 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/16/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4665 WEST BRANCH RD <br /> PIN : 07-117-23-22-0015 <br /> LEGAL DESC : WEST BRANCH HILL <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) <br /> NOTE: $2,000 S/B COLLECTED IN ESCROW FEE <br /> ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000 <br /> HOW DID THEY PAY? CK#3066 &WHO PAID?OWNER:BRIGITTE HAMBLIN <br /> ESCROW PERMIT#:(DON'T FORGET TO ENTER) 2016-01128 <br /> ESCROW FEE FOR: EROSION CONTROL&ENGINEERING REVIEW COSTS <br /> MINOR LAND ALTERATION AND RETAINING WALL. <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> RETAINING WALL<4' 50.00 <br /> &BRIGETTE HAMBLIN,ERIC TRUSKOSKI TOTAL 100.00 <br /> 4665 WEST BRANCH RD <br /> MOUND,MN 55364- Payment(s) <br /> CHECK 3065 100.00 <br /> OWNER <br /> &BRIGETTE HAMBLIN,ERIC TRUSKOSKI <br /> 4665 WEST BRANCH RD <br /> MOUND, MN 55364- <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 ime for due cause. <br /> // , //cP Ci p_.)-,_ 45-6 , /6 / <br /> pl. ant P rmitee Signature Date Issue By Signature Date <br /> i <br />