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CITY of ORONO � <br /> BU1I�IIZg Perinl� PERMIT NO. s`Z2,� � <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED �������� <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT �5 �' �fJ <br /> SITE ADDRESS /�--a <br /> PROPERTY IDENT►FICATION NO.(PID) d' — c3 3 �� vU�S <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE O�NER� (Name) (Address) (Phone) <br /> �� � P .� d � � <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial& In trial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DAT <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH PTH ��n �" �I S 1 � D C. � 3a�• o��/`�"/� <br /> TYPE OF WORK New A ition Remodel Renovat <br /> PR POSED S CKS: <br /> FR T R. E ' <br /> CONST.TYPE BUILDING SIZE Esti ted Construction Valuation <br /> REA SIDE <br /> LA E ETLANDS �' W Ht. v ��v <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION +D. �U <br /> ACCES DWELL. STORIES B 1 2 3 BLDG. PERMIT <br /> UNITS �� (�� <br /> EXISTING STATE FEE <br /> GAR.STALLS NUMBER OF BEDROOMS <br /> AGE C PPROV. DATE qn, PLAN REVIEW <br /> CITY DET. SEPTIC <br /> APP. DATE SAC CHARGE <br /> OUN PROPOSED USE SEWER UNIT <br /> S TE PARK FEE <br /> PENALTY <br /> PRIVAT EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> � <br /> TOTAL DUE �v <br /> REMARKS: <br /> - ���qa7 <br /> WORK REQUIRING ACKNOWLEDGEMENT <br /> INSPECTION REQUIRED SEPARATE PERMITS <br /> ❑ ... . . . FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> ❑ . ... . . FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES <br /> ❑ ... . . . INSULATION MECHANICAL....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> ❑ .... . .WALLBOARD before taping ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> FINAL before occupancy WELL.................... ❑ <br /> .... . . <br /> ...... <br /> ..... . SITE INSPECTION SEPTIC........................ � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SIGNED FURTHER AGREES TO 00 ALL WORK IN STRICT COM- <br /> SEWER.............................. <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. ❑ <br /> GRADING&FILLING ............... ❑ <br /> OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> INSPECTIONS MUST BE CALLED-IN <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ 9 � <br /> Signature �/� �` Date <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved City of Orono <br /> Brooklyn Prtg.&Ativ.Co.Inc. (612)5614470 <br />