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"'' CITY OF ORONO <br /> r * 2 0 1 6 - 0 4 0 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUE : 04/2U2016 <br /> ' ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1255 DICKENSON ST � <br /> PIN : 02-117-23-31-0027 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> � ; LOT 000 BLOCK O15 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL ' <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT , <br /> NOTE: THIS$2500 ESCROW IS TIED TO ZONING PERMIT APPLICATION 16-3830 <br /> APP�.ICANT ESCROW FEE-APPLICANT 2,500.00 <br /> TOTAL ' 2,500.00 <br /> DETTLOFF,MARION Payment(s) <br /> 1255 DICKENSON ST CHECK 2829 i 2,500.00 <br /> WAYZATA,MN 55391- i <br /> OWNER <br /> DETTLOFF,HB JC <br /> 1001 TWELVE OAKS CENTER DR#10 <br /> WAYZATA,MN 55391- <br /> AGREEMEIVT AND SWOR1�1 STATEMENT ' <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specificatiops,applicable City approvals,and the <br /> State Building Code. This permit i�for only the work described and dces <br /> not grant permission for additional r related work which requires separate <br /> permits. All provisions of laws an ordinances goveming this type of work <br /> shall be compied with whether or t specified herein.This permit will <br /> expire and become null and void i construction authorized is not <br /> commenced within 180 days of th date of issuance,or if construction is <br /> suspended for a period of 180 day at any time after work has commenced. <br /> The applicant is responsible for as uring 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 /> i <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />