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j � CITY OF ORONO * 2 0 1 4 - 0 0 3 5 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/23/2014 <br /> ORONO, MN 55356- <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 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> N07�t�:: 7'I[IS$2500 ESCROW IS"CIE�:D�1�0 ZONING PERM["I� 14-3668 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> ESCROW FEE- DEVELOPER 0.00 <br /> BOWMAN, BRADLEY& MARY <br /> 1 165 FERNDALE RD W TOTAL 2,500.00 <br /> WAYZATA, MN 55391- Payment(s) <br /> CHECK 113 2,500.00 <br /> OWNER <br /> BOWMAN, BRADLEY& MARY <br /> 1165 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1"he work for which this permit is issued shall be perCormed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State[3�iilding CoJc. "Chis permit is for only the work described and does <br /> not grant permission tbr additional or related��ork��hich requires separate <br /> permits, All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied 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 /> suspendcd for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confonnance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Pcrmitce Signature Date Issucd By Signaturc Datc <br />