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' CITY OF ORONO liiiiiiiiiiiiiiiiiiiiillillillilI <br /> * 2 0 1 5 - 0 0 6 2 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/19/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 4440 FOREST LAKE LANDING <br /> PIN 07-117-23-24-0017 <br /> LEGAL DESC TONKAVIEW GARDENS <br /> : LOT 012 BLOCK 000 <br /> PERMIT TYPE ESCROW FEE-APPLICANT <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ESCROW FEE-APPLICANT <br /> NOTE: THIS$2,000 ESCROW IS TIED TO ZONING PERMIT 2014-00636 <br /> APPLICANT ESCROW FEE-APPLICANT 2,000.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> CHURCH,JOSEPH TOTAL 2,000.00 <br /> 6175 STONE COURT Payment(s) <br /> INDEPENDENCE,MN 55359- CHECK 2,000.00 <br /> (612)308-7482 <br /> OWNER <br /> CHURCH,JOSEPH <br /> 6175 STONE COURT <br /> INDEPENDENCE,MN 55359- <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 />