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CITY OF ORONO * z 0 1 5 - 0 1 1 3 5 * <br /> , � 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1340 EOX ST <br /> PI(Y : 02-117-23-31-0056 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT MB BLOCK 14 <br /> PERMIT TYPE : ZONING PERM[T <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : LAND ALTERATION (0-500 CU YDS) <br /> NOTE: ESCROW WAS COLLECTED WITH THE NEW BUILD[NG PERMIT-#20 1 5-004 1 3 <br /> NOTE: PRIOR TO RELEASE OF ESCROW,AN AS-BU[LT SURVEY MUST BE SUBM[TTED&APPROVED. INITIAL: v `S�— <br /> APPLICANT MINOR LAND ALTERATION 50.00 <br /> ENGINEERING REVIEW COSTS <br /> CHAMBERLA[N CAPITAL LLC TOTAL 50.00 <br /> 11578 CHAMBERLAIN CT Payment(s) <br /> EDEN PRAIRIE, MN 55344- CHECK 932 50.00 <br /> Minnesota State License#: BUIL-BC661410 <br /> OWNER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLAIN COURT <br /> EDEN PRAIRIE,MN 55344- <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 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 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 /> ' ���-�1__= � ���.L�� �, ��� SC � �j�, l l, � <br /> Applicant Permitee Signature Date [ssued By Signature Date <br />