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CITY OF ORONO * 2 0 1 7 — 0 0 5 PJ 6 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/16/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 Sfit�ecl <br /> ADDRESS 3760 NORTHERN AVE <br /> PIN 17-117-23-34-0051 Ci COFT <br /> LEGAL DESC SOUTHVIEW ESTATES <br /> LOT 003 BLOCK 001 <br /> PERMIT TYPE ESCROW FEE-TIED TO BUILDING PERMIT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-TIED TO BUILDING PERMIT <br /> NOTE: ESCROW FOR PERMIT#2017-00504 FOR ADDITION-PAID BY OWNER:MARY VANDEPUTTE-CK#8178-$700.00 <br /> APPLICANT ESCROW FEE-BUILDING 700.00 <br /> TOTAL 700.00 <br /> VANDEPUTTE,MARY Payment(s) <br /> 3760 NORTHERN AVE CHECK 8178 700.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> VANDEPUTTE,MARY <br /> 3760 NORTHERN AVE <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 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 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 Sta uil hg Code.This permit may be <br /> revokej at any time for due cause. <br /> Applicant Permite ignature Date Issued By Signature Date <br />