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f <br /> ' � " CITY OF ORONO <br /> 2750 KELLEY PARKWAY * Z 0 1 5 - PJ 1 5 6 9 * <br /> DATE ISSUED: 12/16/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2697 ETHEL AVE <br /> PIIY : 20-117-23-24-0045 <br /> LEGAL DESC : REG. LAND SURVEY NO. Ol 15 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: THIS$700 ESCROW IS TIED TO BUILD[NG PERM[T 2015-01786 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> COHEN, MARC& IRV TOTAL 700.00 <br /> Payment(s) <br /> 2697 ETHEL AVE CHECK 1125 700.00 <br /> WAYZATA, MN 55391- <br /> (952)471-7700 <br /> OWNER <br /> COHEN,MARC& IRV <br /> 2697 ETHEL AVE <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 Ciry 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 authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspec[ions 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 />