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4 _� � <br /> CITY OF ORONO * 2 0 1 6 - PJ 1 0 7 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/OU2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 515 KOKESH FARM RD <br /> PIN : 31-118-23-14-0009 <br /> LEGAL DESC : KOKESH FARMS <br /> : LOT 001 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$7500.00 ESCROW IS TIED TO BUILDING PERMIT 2015-01489 FOR A TEMPORARY CERTIFICATE OF OCCUPANCY <br /> APPLICANT ESCROW FEE-BUILDING 7,500.00 <br /> TOTAL 7,500.00 <br /> LITECKY,MARK&ANITA Payment(s) <br /> 515 KOKESH FARM RD CHECK 7187 7,500.00 <br /> MAPLE PLAIN,MN 55359- <br /> OWNER <br /> LITECKY,MARK&ANITA <br /> 515 KOKESH FARM RD <br /> MAPLE PLAIN,MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 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 />