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CITY OF ORONO * 2 0 1 Z - 0 0 6 6 9 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 07/16/2012 <br /> �, ,. ORONO, MN 55356- <br /> r (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1595 MAPLE PL <br /> PIN : 08-117-23-33-0035 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 013 BLOCK 006 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERM[T <br /> NOTE: ESCROW FEE T[ED TO BUILDING PERMIT#2012-00636 FOR NEW HOME PERMIT <br /> APPLICANT <br /> ESCROW FEE-BUILDING 2,500.00 <br /> DEAN JOHNSON HOMES, INC. TOTAL 2,500.00 <br /> 4700 CTY ROAD 19 <br /> MEDINA, MN 55357- <br /> (763)479-4820 <br /> Minnesota State License#: 20639439 <br /> OWNER <br /> Maple Place LLC <br /> 550 25TH AVE N <br /> ST. CLOUD, MN 56303- <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 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 goveming this type of work <br /> shall be compied wi[h 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 /> '1 / i� l ���i z �-��--�_C L.�yyt_C G"�/1 � "�j —/ cF - �, <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />