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CITYofORONO <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY, MN 55323 473-7M7 <br />PERMIT-N9 y 51521 <br />DATE ISSUED /f ^ -53. <br />EXPIRES------------------------------- <br />-s' <br />% 'J <br />ZONING DISTRICT <br />Ln-ife_ <br />FIRE ZONE <br />VAR. DATE <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />FRONT R.SIOE/ <br />20*_______l£ <br />REAR LSIDE. <br />-TSlr <br />LAKE WETLANDS <br />ACCESS <br />new existing <br />AGENCY'APPROV. DATE <br />CITY • <br />COUNTY <br />STATE <br />PR. EASEMENT <br />/ j(JSITE ADDRESS YVS/.---- <br />legal DESCRIPTION: PROP. ID.. 07 <br />lot_______________BLOCK______________mniviSiOM <br />IWNER INamt) {Addtml (Phoof) y72. <br />Iru.LL** U»«ai U»>D.«>b 12Q| <br />ARCHITECT/EN^NEER - Mult Certify Multi-Family, ComfTif»cill & Industrial Construction Plans <br />:ert.no. <br /><Firm)(Address)(Phone) <br />BUILDER <br />I^Ag,L^ <br />(Firm) <br />T>Ar tr <br />(AddrtssI <br />Z3i L L g.«/ <br />(Phone) <br />141? • Z7C<^ <br />ItYPE OF WORK <br />■Der. <br />CONST. TYPE <br />___ Addition Remodel Renovate <br />BLOG SIZE <br />L 32^TM <br />residential <br />DWELL. <br />UNITS <br />CAR. STALLS <br />ATT. <br />OET. <br />NONRESIO. <br />occ. <br />CLASS <br />STORIES <br />STORIES B <br />BORMS/FLR <br />SEPTIC <br />APP. DATE <br />DOCK <br />PROPOSED USE <br />COUNCIL <br />APP. DATE <br />EST. CONST, valuation <br />O C>1^,S‘600. <br />PERMIT FEES <br />BLOG. PERMIT ^ ^ ^ <br />STATE FEE <br />PLAN REVIEW <br />PENALTY <br />oo» <br />1C. <br />SAC CHARGE <br />TOTAL DUE <br />REMARKS: <br />INSPECTION REOUIREO <br />_ FOOTING before pour <br />_ FRAMING rouah in <br />_ INSULATION <br />^WALLBOARO Btfo-e Teping <br />F INAL before cccup«.*.cy <br />WORK BIVONO OR WITHOUT A RE­ <br />QUIRED INSPECTICN WILL BE SUB­ <br />JECT TO PENALTY. <br />INSPECTION HOURS 473-7357 <br />CALLS • 12 A-M. INSP. 1 • 4 P.M. <br />CALL 1 • 4 P.M. INSP. NEXT OAY <br />WORK REQUIRING <br />SEPARATE PERMITS <br />PLUMBING <br />MECHANICAL <br />WELL ______ <br />SEPTIC-------------------- <br />SEWER __________- <br />WATER___________ <br />GRADING* FILLING <br />ELECTRICAL from Slate <br />ACKNOWLEDGEMENT <br />THE UNOERSIGNE": HEREBY REQUESTS PERMISSION TO MAKE <br />THE REAL IMPROVEMENTS SPECIFISO. AND DECLARES <br />UNDER penalty OF LAW ACKNOWLEDGEMENT AND ACCEPT­ <br />ANCE OF all information. CONDITIONS ANO REQUIRE­ <br />MENTS REPRESENTED ON THIS OOCOMENT. THE UNOER- <br />8I0NE0 FURTHER AGREES TO DO ALL WORKS IN STRICT COM­ <br />PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br />ItNG CODE REQUIREMENTS. <br />COPY: WHITE-PILE <br />CANARY-INSPECTOR <br />PINK-AUESSOR <br />GRSEN-PiNANCf <br />GOLD-RECEIPT <br />SOTA^Uj^ <br />^Byamre ^ ✓"fX I ^ <br />Gty of Orono