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I <br />CITYwTOROXO <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357 <br />PERMIT NO. 5848 ' <br />DATE ISSUED <br />ZONING DISTRICT^Lr-iol <br />FIRE DEPARTMENT <br />m cv^ncJ <br />POST OFFICE <br />VAR DATE _ <br />COND USE DATE <br />, DEPTH <br />PROPOSED SETBACKS <br />SlDc / <br />REAR L SIDE y ^ / / <br />LAKE WETLANDS <br />.^SO' <br />ACCESS <br />NEW <br />AGENCYAPPR0V-4MU4 <br />CITY <br />COUNTY <br />STATE <br />PRIVATE EASEMENT <br />SITE ADDRESS_________________________________________ ^ ___________________ <br />PROPERTY IDENTIFICATION NO iPlDl ~ 1 1 ~1- ^ <br />LOT________________BLOCK_____________________ SUBDIVISION_______________________ <br />OWNER (Name)(Address) <br />t Z/\ jQl^kXk <br />ARCHITECT/ENGINEER Must Certify Multi-Family Commercial & Industrial Construction Plans <br />(Firm) (Address) (Phone) <br />BU'LDER <br />Ak'c^'eork (X rc.l o~rr /?N /Jcr 4hrkik ^d. ^5 <br />TYPEOFV/ORK Addition Remodel Renovate <br />fiaric'ipn I Zk <br />CONST TYPE <br />fyUt/lUcl <br />BUILDING SIZE <br />70 <br />OCCUPANCY <br />CLASSIFICATION <br />DWELL <br />UNITS <br />GAR ST <br />ATT___ <br />DFT <br />STORIES B <br />NUMBER OF BEDROOMS'°J/ <br />SEPTIC <br />APP DATE <br />PROPOSED USE <br />COUNCIL <br />APP DATE <br />remarks >SA(L O^Uc^i'i'<;xQACacli,4. f\r-T;tC<^l fo <br />.LL i t / > 1 / y~ <br />Estimated Construction Valuation <br />nno <br />'^PERMIT FEES ^ <br />BLDG PERMIT / <br />STATE FEE <br />PLAN REVIEW 313,7s" <br />SAC CHARGE — <br />SEWER UNIT <br />PARK FEE <br />PENALTY <br />other <br />TOTAL DUE a /4P607S" <br />0 <br />I <br />ECTION REQUIRED <br />FOOTING before pour <br />. . . FRAMING rough-in <br />.... INSULATION <br />.... WALLBOARLi before taping <br />FINAL before occupancy <br />□.............SITE INSPECTION <br />WORK BEYOND OR WITHOUT A RE <br />OUIRED INSPECTION WILL BE SUB <br />JECT TO penalty <br />INSPECTIONS MUST BE CALLED IN <br />HOURS IN ADVANCE <br />WORK REQUIRING <br />SEPARATE PERMITS <br />PLUMBING <br />MECHANICAL <br />WELL <br />SEPTIC <br />SEWER <br />WATER <br />GRADING A FILLING <br />TIRE <br />s□□ <br />#w□□ <br />ACKNOWLEDGEMENT <br />THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE- <br />the RLAl IME’ROVEML NTS SPEClEIED AND DECLARES <br />UNDER penalty OF LAW ACKNOWL FOGE ME NT AND ACCEPT <br />ANCE or 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 MiNNESOfA BuKDiNp CQD REC^UiREMtffTS <br />COF'Y WHiTL HIE <br />canary inspector <br />PINA ASSESSOR <br />•rMfeiyM A Aa» C« Inc «WI «€« 4410 <br />GREEN FINANCI <br />rK)lD RECt'PT <br />Signatuf** <br />AtH*rowe<J <br />.Date <br />(1 '♦ OwHI