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CITY of ORONO _ _ <br /> Buildin Perinl� PERMIT NO. 645�J � <br /> g - 9 -�''7 <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY �ATE ISSUE� _ <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT /, <br /> SITE ADDRESS K- <br /> PROPERTY IDENTIFICATION NO.(PID) <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWN (Name) (Address) (Phone <br /> �7/- 9 s�� <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE D E <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH DE H <br /> TYPE OF WORK New Addition Remodel Renovate <br /> PROPOSED S B � � U�� <br /> FRONT R. IDE <br /> CONST.TYPE BUIIDING SIZE E�i�}nated Construct�n Valuation <br /> REAR l. DE 7y <br /> L. W. H t. �'i .� I� � <br /> LAK ETLANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION , �� <br /> ACCESS DWELL. STORIES g � 2 3 BLDG. PERMIT � S�v <br /> UNITS STATE FEE � _ <br /> N W EXISTING GAR.STALLS NUMBER OF BEDROOMS <br /> AGE Y-AP ROV. DATE ATT. PLAN REVIEW <br /> CITY DET. SEPTIC <br /> APP. DATE SAC CHARGE <br /> COUN PROPOSED USE SEWER UNIT <br /> ATE PARK FEE <br /> PENALTY <br /> PRI E EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> TOTALDUE <br /> REMARKS: �� <br /> ck�hl3c�l <br /> INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT <br /> SEPARATE PERMITS THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO <br /> ❑ . . ... . FOOTING before pour <br /> ❑ . . .... FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND DECLA <br /> ❑ . . .... INSULATION MECHANICAL....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACC <br /> ❑ . . . . . .WALLBOARD before taping ANCE OF ALL INFORMATION, CONDITIONS AND REQU <br /> FINAL before occupancy WELL............................. ❑ <br /> �.. . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UND <br /> WORK BEYOND OR WITHOUT A RE- SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT C <br /> SEWER.............................. <br /> GlUIRED INSPECTION WILL BE SUB- P�IANCE wITH ALL CITY OF ORONO ORDINANCES AND ST <br /> WATER....................... <br /> JECTTO PENALTY. �"""' <br /> OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> GRADING&FILLING ............... ❑ <br /> INSPECTIONS MUST BE CALLED-IN ' <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ • <br /> Signature Date <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT � <br /> PINK-ASSESSOR Approve City of Orory <br /> BrooklVn Prtg.&Adv.Co.Ina (612)561-4470 { <br />