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CITYof ORONO PERMIT No _- 5535I <br /> Building Permit � <br /> DATE ISSUED � " ��� �s <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY EXPIRES <br /> P.0. B OX 66, C R YSl'A L BAY, M N 55323 473-7357 <br /> ZONING DISTRICT SITE ADDRESS 7 0 � <br /> _ I � LEGAL DESCRIPTION: PROP. ID. � � — � ' "' OO <br /> LOT BLOCK SUBDI ViSION <br /> FIRE ZONE <br /> WN R (Name) (Address) (Phone) <br /> VAR. D E �, �p <br /> ARCHITECT/ENGINEER — Must Certify Multi-Family,Comm cial & Industrial Construction Plans <br /> COND. USE T ERT.NO. <br /> (Firm) (Address) (Phone) <br /> LOT ARE - <br /> WIDT DEPTH BUILDER (Firm) (A dress) (Phone) <br /> PROPOSED SETBACKS <br /> FRONT R.SIDE � TYPE OF WORK New Addition Remodel Renovate <br /> REAR L.SIDE� <br /> � �� � d� K — P��►� � S <br /> /5 CONST.TYPE BLDG.SIZE EST. ONST.VALUATION <br /> LAKE WETLANDS <br /> L. W. Ht. �/ U��, OC9 <br /> ACCESS , <br /> RESIDENTIA STORIES B 1 2 3 PERMIT FEES <br /> BLDG. PERMIT SD . J�d <br /> NEW EXISTING DWELL. BDRMS/FLR <br /> AGENCI'-APPROV. DATE UNITS STATE FEE �Q <br /> CITY � GAR.STALLS SEPTIC PLAN REVIEW <br /> ATT. APP. DATE <br /> COUNTY �ET. PENALTY <br /> DOCK <br /> STATE <br /> NON-RESID. PROPOSED USE PARK FEE <br /> PR. EASEMENT OCC. <br /> SAC CHARGE <br /> CLASS. <br /> STORIES COUNCIL <br /> APP. DATE TOTAL DUE S3. OO <br /> REMARKS: /� ,'�y - (� � <br /> INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT <br /> FOOTINGbeforepour SEPARATE PERMITS <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> FRAMING rough-in <br /> INSULATION PLUMBING THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES <br /> WALLBOARD Before Taping MECHANICAL UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> WELL ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> FINAL before occupancy <br /> SEPTIC MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER— <br /> V110RK BEYOND OR WITHOUT A RE- SEWER <br /> QUIRED INSPECTION WILL BE SUB- SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM- <br /> WATER <br /> JECT TO PENALTY. PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> GRADING&FILLING <br /> INSPECTION HOURS 473-7357 OF MINNESOTA B ING CODE REQUIREMENTS. <br /> CALL 8- 12 A.M. INSP. 1 -4 P.M. <br /> CALL 1 - 4 P.M. INSP.NEXT DAY ELECTRICAL from State <br /> Signature � ate /- ��� VJ <br /> COPY: WHITE—FILE GREEN—FINANCE <br /> CANARY—INSPECTOR GOLD—RECEIPT �{/ /�I <br /> PINK—ASSESSOR Approved _ / �� V` � City of Orono <br />