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CITY of OKONO <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357 <br />PERMIT NO. 6215' <br />Jo -31-21^DATE ISSUED <br />ZON^ DISTRICT <br />FIRE DEPARTM^T <br />POST OFFICE <br />C • L* <br />VAR. DATE <br />COND. USE DATE <br />LOT AREA _ ^ 1 <br />WIDTH , DEPTH <br />koo't- /i,d'Jz <br />PROPOSED SETBACKS: ^ r\ i i <br />REAR L. SIDE <br />''5d,0' SOO'-^ <br />LAKE WETLANDS <br />ACCESS <br />.EXISTING <br />aIgeu C y-approv . date <br />COUNTY <br />STATE <br />PRIVATE EASEMENT <br />SITE ADDRESS. <br />PROPERTY IDENTIFICATION NO. (PID) <br />LOT____I______BLOCK i <br />HK^dcjl LOg..,. <br />Jtn ^ <br />SUBDIVISION /^r>n /^l4^r\ <br />(Address)(Phone)OWNER (Name) <br />ARCHITEC^/ENGINEER “ Musi cierTi^^ Mulli-Family. Commercial & Industrial Construction Plans <br />(Phone)(Firm) <br />K‘C-IwiajJI pk. <br />(Address) <br />BUILDER (Firm) ' (Address) <br />l~^n(ffmar\C P,Cfs4-. /-^nc/-A.K.<L Wn <br />(Phone). ,^7 3-a^ <br />TYPE OF WORK /^ew) Addition^ <br />&S. <br />Remodel Renovate <br />CONST. TYPE BUILDING SIZE <br />W.Ht <br />OCCUPANCY <br />CLASSIFICATION <br />DWELL. <br />UNITS <br />STORIES B 1 2 3 <br />GAR. STALLS <br />ATT. <br />DET. <br />NUMBER OF BEDROOMS <br />SEPTIC . <br />APP. DATE / O'^O' y(o <br />PROPOSED USE <br />COUNCIL <br />APR DATE <br />REMARKS: <br />Estimated Construction Valuation <br />1^X000. <br />BLDG. PERMIT <br />STATE FEE <br />PLAN REVIEW <br />SAC CHARGE <br />SEWER UNIT <br />PARK FEE <br />PENALTY <br />OTHER <br />PERMIT FEES <br />9 <br />M7iT.- oo <br />TOTAL DUE IS 33. oo <br />INSPECTION REOUIRED <br />.........FOOTING bcloro pour <br />WORK REQUIRING <br />SEPARATE PERMITS <br />........FRAMING rough-in PLUMBING............................□ <br />&..........INSULATION MECHANICAL.........................□ <br />&...........WALLBOARD before taping <br />WELL..................................n>3...........FINAL before occupancy <br />^...........SITE INSPECTION SEPTIC...................................□ <br />WORK BEYOND OR WITHOUT A RE­SEWER...................................□ <br />OUIRED INSPECTION WILL BE SUB­WATER................................. <br />GRADING & FILLING........... <br />nJECT TO PENALTY...□ <br />INSPECTIONS MUST BE CALLED-IN <br />24 HOURS IN ADVANCE.FIRE.......................................□ <br />COPY: WHITE-FILE <br />CANARY-INSPECTOR <br />PINK-ASSESSOR <br />firooVlyn PM9. & Atfv. Co Inc. 1613) 56M470 <br />GREEN-FINANCE <br />GOLD-RECEIPT <br />ACKNOWLEDGEMENT <br />THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br />THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES <br />UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT­ <br />ANCE Of ALL INFORMATION. CONDITIONS AND REQUIRE­ <br />MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER­ <br />SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM­ <br />PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br />OF MINNESOTA BUILDING/)ODE REQUIREMENTS <br />Signature. <br />r/ <br />.Dale <br />Approved .City of Orono