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� .~ CITY OF ORONO PERMIT NO.: 2012-00055 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuED: OU25/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3340 GRAHAM HILL RD <br /> PIN : OS-117-23-11-0012 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 2 <br /> : LOT 4 BLOCK 2 <br /> PERM[T TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILD[NG PERMIT <br /> NO"[T: TNIS$2500 ESCROW IS TIED TO BU[LDING PERMIT#201 1-01537 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> MCCARTY, LEROY& LISA TOTAL 2,500.00 <br /> 3340 GRAHAM HILL ROAD <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> MCCARTY, LEROY & LISA <br /> 3340 GRAHAM H[LL ROAD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[�s issued shall be performed according to <br /> the approved plans and speciticauons,applicable City approvals,and the <br /> State Bwlding Code. This permit�s for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permrts. AII provisions of laws and ordinances governing this rype of work <br /> shall be compied with whether or nol 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'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[ime for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued 13y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />