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CITY OF ORONO * 2 0 1 7 — 0 0 5 3 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/19/2017 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1885 CONCORDIA ST <br /> PIN : 17-117-23-23-0002 ����� �` �' <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-T[ED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR TEMP CERTIFICATE OF OCCUPANCY-PERMIT#2016-00486-PAID BY OWNER:CAROLYN&BERNARD <br /> KAISER-PA[D CK#4425-$7,500.00 <br /> APPLICANT ESCROW FEE-BUILDING 7,500.00 <br /> TOTAL 7,500.00 <br /> KAISER,BERNARD&CAROLYN Payment(s) <br /> 2855 PROVIDENCE PLACE CHECK 4425 7,500.00 <br /> INDEPENDENCE,MN 55359- <br /> OWNER <br /> KAISER,BERNARD&CAROLYN <br /> 2855 PROVIDENCE PLACE <br /> INDEPENDENCE, MN 55359- <br /> AGREEME1vT AND SWORIv 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 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 /> i <br /> �� G�'�Gc�—� � S `1 /� Ci�--e/J f��-e�e.�`�� `� f 9i / I <br /> Applicant Permite �gnat e D te [ssued By Signature Date <br />