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,, CITY OF ORONO PERMIT NO.: 2012-00043 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OU18/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1 165 FERNDALE RD W <br /> PIN : 02-117-23-43-0026 <br /> LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE <br /> : LOT 000 BC.00K 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIVSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOT�: 1'HIS$2�00 ESCROW IS TIED TO ZON[NG PERMIT APPLICATION#12-3544 AND PAID FOR BY CHARLES CUDD DENOVO <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> BOWMAN, BRADLEY& MARY TOTAL 2,500.00 <br /> 1 165 FERNDALE RD W <br /> WAYZATA, MN 55391 <br /> OWNER <br /> BOWMAN, BRADLEY& MARY <br /> 1 165 FERNDALE RD W <br /> WAYZATA, MN 5539] <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 /> S[ate 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 goveming this type of work <br /> shall be compied with H�hether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced widiin 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time aRer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any t�me for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />