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<br /> I ;' CITY ()f OR(VNO _
<br /> PERMIT �) 4624
<br /> [1 . Building Permit 9�.�s=�Y/ -
<br /> DATE ISSUED �.
<br /> 4, . AND APPLICATION FOR CERTIFICATE OF OCCUPANCY l 7-.1 �� EXPIRES
<br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473.7357 �/ /�
<br /> ZONING DISTRICT SITE ADORESs F3 / �1 re /Or/1/6
<br /> LEGAL DESCRIPTION: PROP. ID. .-1 /7-A3 zil Cn ildf ,
<br /> LOT- _ _ BLOCK_____ SUBDIVISION_
<br /> FIRE ZONE IMINIIIIIII
<br /> IWN-R i (Na e) (Address) (Phone) •
<br /> VAR. DATE _ .1 e' //Q,-/ ,v/?x. ,I7/ -gc
<br /> ARCHITECT/ENC!NEER – Muse Certify Multi-Family,Commercial & Industrial Construction Plans
<br /> COND. USE DATE .ERT.NO. ____—
<br /> ti
<br /> (Fi4.. /y
<br /> (Address) (Phone)
<br /> LOT AREA 3it:tln PaUly -'�rilidi/ C (j1',I'a. ,41/Te
<br /> WIDTH DEPTH BUILDEr+ (Firm) (Address) (Phone)
<br /> PROPOSED SETBACKS
<br /> FRONT R.SIDE TYPE Of 1,ORK New Addition Remodel Renovate
<br /> • REAR L.SIDE —
<br /> fit/ " /., n G c/�t / 35c102 ,{/.S, b•
<br /> COV.^r ' t'ETER IH, SI:E .esb Z) 1 # , EST. •• ONS T.VALUATION
<br /> LAKE WETLANDS / ,;,�,v i De.??,r
<br /> „ O % H. 1//n . ,,
<br /> „,‘ , ACCESS FIF,IDLNII.,I; '.,r0RIIS B t ' a PERMIT FEES
<br /> z' BLDG. PERMIT 2l`' - DD
<br /> • t, NEW EXISTING tr.'.. l I. BURN'S Fut �-
<br /> '' AGENCY-APPROV. DATE . SO r'
<br /> O;I,. STATE FEE G'
<br /> s CITY ,,;I” L
<br /> ' :' F APP DA PLAN REVIEW
<br /> rix COUNTY DET PENALTY
<br /> ; DUCK
<br /> f`t STATE No I I!,"1 1"i0POSEt)USE PARK FEE
<br /> sus
<br /> f — — SAC CHARGE1.
<br /> 7`� a' PR< EASEMENT "cr
<br /> , `' CLASS.
<br /> 4.,, — — STrtl:lr— —,,,,,,Cft Y
<br /> `' APP DATE TOTAL DUE
<br /> •
<br /> '1 '' REMARKS: /�L_ (lha, l <<"3 ,sLz 11 /er , �'lZC.Q d dJ itiketh, x_
<br /> eft;' • INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT:� SEPARATE PERMITS
<br /> 9� ;Y' OOTI vG before poo, THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
<br /> _,__FRAMING rough"in
<br /> 5 . INSULATION PLUMPING __ . . THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES
<br /> _WALLBOARD Before E,H nT MECHANICAL _ - _. UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
<br /> WELL _- ANCE OF ALL INFORMATION• CONDITIONS AND REQUIRE-
<br /> —'---_FINALbeforecx:cupancy - .- . ..
<br /> SEPTIC --.-- 'F
<br /> MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER– ,,
<br /> WORK BEYOND OR WITHOUT A RE SEWER
<br /> SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM ',
<br /> QUIREO INSPECTION WILL BE SUBSIGNED
<br /> a,k < JECT TO PENALTY, PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
<br /> GRADING 8, E TEEING
<br /> INSPECTION HOURS 4/3'13b7 OF MINNESOT BUIL ING C DE REQUIREMENTS.
<br /> CALL8- '2 A.M INSP. 1 • 1 P.P.'
<br /> CALL 1 " 4 P.M. IT $P.NI xT DAY ELECT"TUC\L born St,i;e
<br /> + ._ - Si9na!ure Date
<br /> COPY WHITE FILE GHIEN F INAN.,! — '
<br /> .'" ,, CANARY- INSPECTOR GOO) RECEIPT S ,
<br /> PINK ASSESSOR Appro\ed % 2Ljj O -rte /.
<br /> ••••1 d C'F 0of Orono r
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