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t <br />n <br />CITYofOROXO <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />PERMIT NO. 6385 ' <br />DATE ISSUED ^ / - <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357 <br />ZONING BIS/TRICTVI <br />FIRE DEPARTMENT <br />POST OFFICE iL <br />VAR DATE. <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />FRONT <br />lEAR L SIDE <br />LAKE WETLANDS <br />/O <br />ACCESS <br />NEW '^XISTINJj/ <br />AGENCYAPPWV'TJATE <br />CITY <br />COUNTY <br />STATE <br />PRIVATE EASEMENT <br />SITE ADDRESS. <br />PROPERTY IDENTIFICATION NO <br />lot_____________BLOCK <br />■^t^i rai>cc fh HjO <br />ci.-ATinK. Kin iPini ■ n f V OC>/'? <br />SUBDIVISION <br />O^ER , (Name) . (Address) /I <br />Cbt n CjiSC^ fVr-^— <br />ARCHI"i^CT/ENGINEER - Must Certify Multi-Family. Commercial & Industrial Construction Plans <br />(Pirm) lAddressi (Phonel <br />BUILDER (Firm)(Address)(Phone) <br />J T <br />7)4 Pn'i^)■ //>/!(/ ^{U>u^ I^Jl <br />^PE (JFWORK ^ Addition ^ RerRemodel <br />tj <br />Renovate <br />CONST TYPE BUILDING SIZE <br />OCCUPANCY <br />CLASSIFICATION <br />DWELL <br />UNITS <br />GAR STALLS <br />ATT <br />DET. <br />STORIES B © <br />NUMBER OF BEDROOMS ^ <br />SEPTIC <br />APP DATE <br />PROPOSED USE <br />REMARKS <br />Esiimated Construction Valuation <br />PERMIT FE£S <br />BLDG PERMIT <br />STATE FEE <br />PLAN REVIEW <br />SAC CHARGE <br />SEWER UNIT <br />PARK FEE <br />PENALTY <br />OTHER <br />/S'£..5!5, <br />AJ4 <br />W. <br />'Ardf. Airth, ■!■! et 4o oMiC, <br />nn pfA tyn 4 “ <br />total out 1,11^1 S'i' <br />INSPECTION REQUIRED <br />^..............footing belore pour <br />Xi..............FRAMING rough-tn <br />&..............INSULATION <br />..........WALLBOARO belore taping <br />..........FINAL belore occupancy <br />..........SITE INSPECTION <br />WORK BEYOND OR WITHOUT A RE <br />QUIRED INSPECTION WILL BE SUB <br />JECT TO PENALTY <br />INSPECTIONS MUST BE CALLED-IN <br />24 HOURS IN ADVANCE <br />WORK REQUIRING <br />^PARATE PERMITS <br />h^^j^hex^ <br />PLUMBING..................... <br />MECHANICAL............ <br />WELL <br />SEPTIC ................. <br />SEWER........................ <br />WATER ................. <br />GRADING & FILLING <br />FIRE ........................ <br />0□□ <br />§□□ <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 CODE REQUIREMENTS <br />Siqnaturt*, <br />COPY WHITE file <br />CANARY INSPECTOR <br />PINK ASSESSOR <br />trook'vn A Co Inc <br />GREEN finance <br />GOLD RECEIPT <br />At proved <br />-----Dale <br />^ tiiJ .C*tv of Orono <br />J