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GlTYoTORONO <br />Building Permit PERMIT NO. <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357 <br />DATE ISSUED <br />5670 <br />ZONI^ DISTRICT <br />Vf(- JA <br />FIRE DEPARTMENT, /Tu * <br />VAR Da W <br />COND. USE DATE <br />LOT AREA __ ^/sAct <br />WIDTH /j, DEPTH ,. <br />(^OO ' C/OG ^ <br />PROPOSED SETBACKS: <br />REAR ^ L SIDE <br />LAKE WETLANDS <br />ACCESS <br />existing <br />AdfeWCT-APPROV DATE <br />CITY <br />COUNTY <br />STATE <br />.—-— <br />"PWIVATC CASEMENTJ <br />SITE ADDRESS, <br />PROPERTY IDENTIFICATION NO (PID) <br />LOT________ <br />ATIONNO lPIDl - cS <br />.BLOCK./___ SUBDIVISION '"7^C /“7^/^ <br />OWf^(Nam^(Address)------------ (Phone) <br />Dcha7/xA jQ'j. cJ75- <br />ARCHITECT/ENGINEER - Must Certify Multi-Family. Commercial & Industrial Construction Plans <br />(Firm) (Address) (Phone) <br />BUILDER (Firm)(Address) <br />~ (Ne^ AdTYPE OF WORK <br />(Phone) <br />Addition Remodel Renovate <br />CONST. TYPE BUILDING SIZE <br />L. W O Ht.^ ? <br />OCCUPANCY <br />CLASSIFICATION <br />DWELL. <br />UNITS <br />GAR. STALLS <br />ATT. <br />DET. <br />STORIES B 1 <br />NUMBER OF BEDROOMS <br />SEPTIC <br />APP DATE <br />PROPOSED USE <br />COUNCIL <br />APP. DATE <br />REMARKS: <br />Estimated Construction Valuation <br />*r9 r. <br />PERMIT FEES <br />BLDG. PERMIT S^O <br />STATE FEE <br />PLAN REVIEW <br />SAC CHARGE <br />SEVER UNIT <br />PARK FEE <br />PENALTY <br />OTHER <br />^JS.OO <br />TOTAL DUE /5*70.-»» <br />INSPECTION REOUIRED <br />... FOOTING before pour <br />... FRAMING rough-in <br />.. . INSULATION <br />... WALLBOARO 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 />24 HOURS IN ADVANCE. <br />V;ORK REOUIRING <br />SEPARATE PERMITS <br />PLUMBING............... <br />MECHANICAL........... <br />WELL .................. <br />SEPTIC....................... <br />SEWER ................... <br />WATER.............. .. <br />GRADING A FILLING <br />FIRE ........................ <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 MINNESOTAJ^IMING CODE REQUIREMENTS <br />Signature <br />COPY WHITE-FILE <br />CANARY-INSPECTOR <br />PINK-ASSESSOR <br />Prat, a A«» 0*. IM MI3IMt44?e <br />GREEN-FINANCE <br />GOLD RECEIPT <br />Approved