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' � CITYOFORONO * z0 13 - 00293 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/26/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3210 GRAHAM HILL RD <br /> PIN : OS-117-23-11-0009 <br /> LEGAL DESC : GRAHAM HILL PRESERVE-2 <br /> : LO'I' 1 BLOCK 2 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILUING PERMIT <br /> NOTE: "I�HIS$2500.00 ESCROW IS TIED"I'O BUILDING PI?RMI"I�2013-00292-PD C]II:CK/#7007 <br /> APPLICANT ESCROW FEE- BUILDING 2,500.00 <br /> MESENBURG, MA"I'T& MICHELLE ESCROW FEE- EROSION CONTROL 0.00 <br /> 2525 KELLER ROAD <br /> LONG LAKE, MN 55356- ESCROW FEE-GRADING 0.00 <br /> TOTAL 2,500.00 <br /> OWNER <br /> MESENBURG, MATT& MICHELLE <br /> 2525 KELLER ROAD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEME1vT <br /> The work for�vhich this pennit is issued shall be periormed according ro <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only Ihe work describcd 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 ti�ith whether or not specified herein."I�his permit will <br /> e�pire 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 al[er work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.'l�his pennit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date [ssued By Si�;naturc Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />