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� . CITY OF ORONO * 2 0 1 3 - P1 0 1 9 6 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 03/22/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3205 GRAHAM HILL RD <br /> PIN : OS-117-23-14-0065 <br /> LEGAL DESC : GRAHAM HILL PRESERVE <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$7500 ESCROW IS FOR THE TEMPORARY CERTIFICATE OF OCCUPANCY-PD BY MATT KISSNER-CHECK#2845 <br /> APPLICANT ESCROW FEE-APPLICANT 7,500.00 <br /> KISSNER, MATT&NEENA ESCROW FEE-DEVELOPER 0.00 <br /> 505 S IOTH STREET <br /> MINNEAPOLIS, MN 55404- TOTAL 7,500.00 <br /> OWNER <br /> KISSNER, MATT&NEENA <br /> 505 S IOTH STREET <br /> MINNEAPOLIS, MN 55404- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifica[ions,applicable City approvals,and the <br /> State Building Code. This permi[is for only the work described and does <br /> not grant permission for additional or rela[ed work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified hereia This permit will <br /> expire and become null and void if cons[ruction 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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />