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� � <br /> CITY OF ORONO * z 0 1 5 - 0 0 7 z 0 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: 06/08/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1161 ELMWOOD AVE <br /> PIN : 07-117-23-14-0029 <br /> LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS$7500 ESCROW IS TIED TO BU[LDING PERMIT-2013-01266 FOR TEMP CERTIFICATE OF OCCUPANCY <br /> APPLK:ANT ESCROW FEE-APPLICANT 7,500.00 <br /> ESCROW FEE-DEVELOPER 0.00 <br /> SUNDBERG, RICHARD TOTAL 7,500.00 <br /> 5125 WEST STREET Payment(s) <br /> GREENWOOD, MN 55331- CHECK 1313 7,500.00 <br /> OV1-'nf ER <br /> SUNDBERG, RICHARD <br /> 5125 WEST STREET <br /> GREENWOOD,MN 55331- <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 goveming this rype 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 wi[hin 180 days of the date of issuance,or if construc[ion is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all requiced 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 />