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�' -'` CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 3 - PJ 0 6 5 1 * <br /> DATE ISSUED: 07/16/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1105 FERNDALE RD W <br /> PIN : 02-117-23-43-0033 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0441 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : ESCROW FEE-TIED TO BU[LDING PERMIT <br /> PROPERTY TYPE : RES[DENTIAL <br /> COIVSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NO�I�E: "I'HIS$2500 FSCROW IS TI3�:D TO BUILDING PERMI"I'#2013-00308-PAID CHGCK#7416 PD BY BUILDER JEFF NFLSON <br /> APPLICANT ESCROW FEE- BUILDING 2,500.00 <br /> TRUWIT, CHIP ESCROW FEE- EROSION CONTROL 0.00 <br /> 1 105 FERNDALE RD W <br /> WAYZATA, MN 55391- ESCROW FEE-GRADING 0.00 <br /> TOTAL 2,500.00 <br /> OWNER <br /> TRUWIT, CHIP <br /> 1105 FERNDALE RD W <br /> WAYZATA, MN 55391- <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 Codc. 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 Yor 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 /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMiTS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />