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� ' CITY OF ORONO <br /> * 2 0 1 2 - 0 0 7 1 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/30/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1473 BAY RIDGE RD <br /> PIN : 10-117-23-34-0005 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0192 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZON[NG 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 $2,000.00 <br /> HOW DID THEY PAY? CHECK# 12998&WHO PAID?THOMAS MCCUNE <br /> ECROW PERMIT#:(DON'T FORGET TO ENTER) 2012-00720 <br /> ESCROW FEE FOR: EROSION CONTROL&ENG[NEERING REVIEW COSTS <br /> ZONING PERMIT-INCLUDES DRNEWAY PERMIT AND MINOR LAND ALTERATION-PATIO <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> MCCUNE, THOMAS ENGINEERING REV[EW COSTS <br /> 1473 BAY RIDGE RD TOTAL 50.00 <br /> WAYZATA, MN 55391- <br /> OWNER <br /> MCCUNE,THOMAS <br /> 1473 BAY RIDGE RD <br /> WAYZATA, MN 55391- <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 authorizcd is not <br /> commenced within 180 days of the da[e of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revok any time for due cause. <br /> � 07 � 3/ �/L <br /> � l�D� / z-- <br /> Applicant Permitee Si nature Date Issue Qy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />