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CITY OF ORONO * Z 0 1 2 - 0 1 0 8 3 * <br /> 2750 KELLEY PARKWAY �ATE ►SSUE�: 10/31/2012 <br /> � ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1501 BAY R[DGE RD <br /> PIN : ]0-117-23-34-0007 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0192 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ZONING PERMIT <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : LAND ALTERATION (501+CU YDS) <br /> NOTE: $AMOU1�"C TO BE DETERMINED BY CUP-S/Q COLLECTED IN ESCKOW FEL <br /> *FINAL INSPECTION TO BG PERI'ORMED B Y GNGINGGR.JESSG STRUVE. GRADING MUST BE APPROVI;D BY CI I Y ENGINGGR <br /> 13EFORG ESCROW WILL BG REFUNDED. (INITIAL) <br /> ACTUAL GSCKOW FEE AMOUN"I'COLLEC'I'ED $2,000 <br /> HOW DID THGY PAY? CHECK#2930 &WHO PAID?DON GERMANSON <br /> ESCROW PERMIT#:(DON'T FORGET TO GNTER) O�DIp� -���� <br /> ESCROW FF,1=,I'OR: EROSION CONTROL& ENGINGGRING RI?VIEW COS"I'S <br /> APPLICANT MAJOR LAND ALTERATION 50.00 <br /> GERMANSON, DON &TWILA ENGINEERING REVIEW COSTS <br /> 150] BAY RIDGE RD <br /> WAYZATA, MN 55391- TOTAL 50.00 <br /> OWNER <br /> GERMANSON, DON &TWILA <br /> 1501 BAY RIDGE RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he 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 E3uilding Code. This permit is for only the work described and does <br /> not grant pennission for additional or relaled 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 bccome null and void if construction authorized is not <br /> commenced within I RO days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has conunenced. <br /> The applicant� esponsib or�suring all required inspections are <br /> requested in onTorinanc with�fhe State Quilding Code.This permit may bc <br /> revoked at tinte for e o�use. <br /> `,, <br /> ; - l l � %'Y!/[-�C- /D / 3/ l / Z <br /> App Ea e ec S�gnature Date Issu By Signature Datc <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />