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CITY OF ORONO PERMIT NO.: 2011-01307 <br /> 2750 KELLEY PARKWAY <br /> 1 ORONO, MN 55356- �ATE 1sSUEv: 10/24/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 300 BROWN RD S <br /> PIN : 03-117-23-13-0002 <br /> LEGAL DESC : UNPLATTED 03 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-OTHER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-OTHER <br /> NOTE: THIS$2500 ESCROW IS CONNECTED TO DEMOLITION PERMIT#2011-01253 <br /> APPLICANT ESCROW FEE-OTHER 2,500.00 <br /> CHALFEN, RICHARD TOTAL 2,500.00 <br /> 300 BROWN RD S <br /> LONG LAKE,MN 55356- <br /> OWNER <br /> CHALFEN, RICHARD <br /> 300 BROWN RD S <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performcd 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 separa[e <br /> permits. All provisions oY 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 Statc 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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />