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� • CITY OF ORONO rERMiT rro.: 2011-01233 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE 1ssvED: 10/12/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3510 BAYSIDE RD <br /> PIN : OS-117-23-13-0016 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: TIED TO BUILDING PERMIT 2011-01182 SWIMMING POOL <br /> PD BY GREGG LARSEN CK 2187 10/12/1 1 <br /> APPLICANT ESCROW FEE-BUILDING 2,500.00 <br /> LARSEN, GREGG& STEPHANIE <br /> 3510 BAYSIDE RD TOTAL 2,500.00 <br /> LONG LAKE, MN 55356- <br /> OWNER <br /> LARSEN, GREGG & STEPHANIE <br /> 35]0 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc 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 Buiiding Code. This permit is for only the worh described and does <br /> not grant permission for additional or rela[ed work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shail 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 /> cequested 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 lssued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />