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, ~'' • � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 3 - 0 P1 8 3 9 * <br /> DATE ISSUED: 08/2U2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4325 CHIPPEWA LA <br /> PIN : 31-118-23-42-0009 <br /> LEGAL DF.SC : CHIPPEWA <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NO"CE: `l�l i1S$700 ESCROW IS"1'IED TO VnR1ANCE APPLICATION - 13-3632-PD CHF,CK#2925 <br /> APPLICANT ESCROW FEE-APPLICANT 700.00 <br /> DALE ROBERT RICHARDSON ESCROW FEE-DEVELOPER 0.00 <br /> 15405 NORTH EDEN DRIVE <br /> EDEN PRAIRIE, MN 55346- TOTAL 700.00 <br /> (612)708-6085 <br /> OWNER <br /> PETRUSA, JOSEPH&JANELLE <br /> 4325 CHIPPEWA LA <br /> ORONO, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he work I�or which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State E3uilding 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�oveming this type of work <br /> shall be compied wilh whethcr or not specitied hercin.This permit will <br /> expire and become null and void if'construction authorized is not <br /> commcnced 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 tbr assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit ma��bc <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued I3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHGR THAN DESCRIBED ABOVE. <br />