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CITY of ORONO _ <br /> Building Permit PERMIT NO. 5759 <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICTa5 <br /> SITE ADDRESS <br /> PROPERTY IDENTIFICATION NO.(PID) 3 (.20 <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWNER (Name) (Address) (Phone) <br /> S SS226= 1 <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family, mmercial Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT ARE BUILDER (Firm) 3(ArJddrOess) h n• I MP JS(Phone) <br /> WI H DEPTH /6b. � _ -� <br /> TY E OF WORK New Addition R model novate <br /> PR S D SETBACK . <br /> FR N R.SIDE C ►� r <br /> ITCONST.TYPE BUILDING SIZE Esti ated Construction V uation <br /> REIR I E <br /> L <br /> LAKE ANDS L. W. Ht. <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATIONy� <br /> ACCESS DWELL. STORIES B 1 2 3 BLDG. PERMIT S�• SCS <br /> UNITS STATE FEE <br /> NEW EXISTING GAR.STALLS NUMBER OF BEDROOMS <br /> AGENCY-APPROV. DATE ATT. PLAN REVIEW <br /> CITY DET. SEPTIC <br /> SAC CHARGE <br /> APP. DATE <br /> COUNTY PROPOSED USE SEWER UNIT <br /> STATE PARK FEE <br /> PENALTY <br /> PRIVATE EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> TOTAL DUE <br /> REMARKS: <br /> INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT <br /> ❑ .. .. . . FOOTING before pour SEPARATE PERMITS 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 /> E] . . . . . .WALLBOARD before taping WELL............................... ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> ❑ <br /> x . . . .. FINAL before occupancy <br /> ❑ . . . . .. SITE INSPECTION SEPTIC.............................. ❑ MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE SEWER.............................. El SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> QUIRED INSPECTION WILL BE SUB- WATER.............................. ❑ PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. <br /> GRADING&FILLING ............... E] OF MINNESOTA BUI ING CODE REQUIREMENTS. <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 Approved ty of Orono <br /> Brooklyn Mg.&Adv.Co.Inc. (612)561-4470 <br />