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# • � <br /> CITYOFORONO * z012 - PJ0504 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/07/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1685 FOX ST <br /> PIN : 03-117-23-44-0004 <br /> LEGAL DESC : HANSER ADDN <br /> : LOT 002 BLOCK 001 <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$2500 ESCROW IS TIED TO PERMIT 2012-00258 PAID BY NIVIN MAC MILLAN-CHECK#7779 <br /> APPLICANT <br /> ESCROW FEE-BUILDING 2,500.00 <br /> HORNIG, STEVEN TOTAL 2,500.00 <br /> 1685 FOX ST <br /> WAYZATA, MN 55391- <br /> OWNER <br /> HORNIG, STEVEN <br /> 1685 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMEIVT AND SWORN STATEMENT <br /> fhe work for which this permit is issued shall be performed according[o <br /> the approved plans and specifica[ions,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not gran[permission for additional or related work which requires separa[e <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 /> cxpire 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 180 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 /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />