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CITY OF ORONO * Z 0 1 6 — 0 1 5 Z 5 * <br /> �• 2750 KELLEY PARKWAY DATE ISSUED: 12/09/2016 <br /> . � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 525 KEENE AVE <br /> PIN : 02-117-23-31-0027 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK O15 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIYSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> ��,n <br /> NOTE: ESCROW FOR NEW HOME PERMIT C.O.#2016-00640-PAID BY:ZEHNDER HOMES-CK#3055-$7>500.00 <br /> APPLICANT ESCROW FEE-BUILDING 7,500.00 <br /> TOTAL 7,500.00 <br /> ZEHNDER HOMES INC Payment(s) <br /> 4400 BLUEBELL TRAIL S CHECK 3055 7,500.00 <br /> MEDINA, MN 55340- <br /> Minnesota State License#: BUIL-BC582356 <br /> OWIYER <br /> FORD, CHRISTOPHER&MELISSA <br /> 525 KEENE AVE <br /> WAYZATA, MN 55391- <br /> AGREEMEIYT 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 governing 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 I80 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 alI 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 /> / `� �� <br /> li ��Jl ��---��.e. t���� _ / 7 / �� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />