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CITY OF ORONO * z 0 1 5 - 0 1 4 P1 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/30/2015 <br /> � ' ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 100 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0016 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 005 BLOCK 001 <br /> PERM[T TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERM[T <br /> NOTE: ESCROW TIED TO NEW HOME PERMIT#2015-01350-PAID BY:BARRY&KRIS PETERS-CK#9251-$2,500.00 <br /> APPLICAIVT ESCROW FEE-BUILDING 2,500.00 <br /> TOTAL 2,500.00 <br /> PETERS, BARRY& KRIS Payment(s) <br /> 19210 HACKAMORE ROAD CHECK 9251 2,500.00 <br /> CORCORAN,MN 55340- <br /> OWNER <br /> PETERS, BARRY&KRIS <br /> 19210 HACKAMORE ROAD <br /> CORCORAN, MN 55340- <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> � - � c� � C �.L�t�� � � �_ , _ <br /> � ����i � ��- , � � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />