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. CITY OF ORONO PERMIT NO.: 2011-00118 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 02/22/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 120 CREEK R1DGE PASS <br /> PIN : 03-117-23-12-0014 <br /> LEGAL DESC : CREEKSIDE ►N ORONO <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : ESCROW FEE—TIED TO BUILD[NG PERM[T <br /> PRONERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE—TIED TO BUILDING PERMIT <br /> NO�CE: GSCROW FOR NEW'I IOMG 13UILDING PGRMI'1�#20 1 1-00 1 00 <br /> APPLICANT ESCROW FEE— BUILDING 2,500.00 <br /> GUSTAFSON, MICHAEL& SUSAN TOTAL 2,500.00 <br /> 1000 SHELARD PKWY#300 <br /> M[NNEAPOLIS, MN 55426— <br /> OWNER <br /> GUSTAFSON, MICHAEL cX SUSAN <br /> 1000 SHELARD PKWY #300 <br /> MWNEAPOLIS, MN 55426— <br /> AGREEMENT AIYD SWORN STATEMENT <br /> Thc���ork�br���hich this perntit is issued shall be per�bnned according ro <br /> Ihe approved plans and specitications,applicable City approvals,and the <br /> State Building Codc. This permit is for only the�a�ork described and docs <br /> not grant permission for additional or related�cork�vhich requires separatc <br /> permit�. ��II pro��isions ot�la��'s and orelinances govcrning this type of���ork <br /> shall be compicd�vi[h��'hether ar not specificd hercin. l�his pennit will <br /> espire and become null and void it�construction authorized is not <br /> commenccd���ithin l80 d��y�s ol Lhe date of issuancc,or if construction is <br /> suspcnded for a period oC 180 days at an� time aftcr���ork has commenced. <br /> The applicant is responsible 1or assuring all reyuired inspections are <br /> rcqucsted in conlormancc���ith lhe Slate Building Code.7�his permit may be <br /> revoked at an��time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued B��Signature Datc <br /> SEPARf1TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />