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:ITY of ORONO vL/ <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 - <br />F <br />ING DISTRICT <br />ZONE <br />VAR. DATE <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />FRONT <br />R.SIDE <br />REAR L.SIDE <br />LAKE WETLANDS <br />ACCESS <br />NEW EXISTING <br />AGENCY-APPROV. DATE <br />CITY <br />COUNTY <br />STATE <br />PR. EASEMENT <br />REMARKS <br />SITE ADDRESS -21 <br />LEGAL DESCRIPTION <br />LOT 7 <br />PERMIT N? - 4156 <br />DATE ISSUED <br />EXPIRES <br />PROP. ID. <br />BLOCK SUBDIVISION VIIV <br />WNE <br />(N ) (Address) <br />(Phone) <br />3Ra29 <br />AR ITECT INEER — YuWCertify Multi Famil <br />Commercial & Industrial <br />nstruction Plans <br />(Firm) (Address) <br />(Phone) <br />BUILDER <br />rm (Address) <br />(Phone) <br />TYPE OF WORK New Addition <br />Remodel <br />Renovate <br />CONST, TYPE <br />BLDG. SIZE <br />EST. CONNjSTT.. VALUATION <br />L. W. Ht. <br />RESIDENTIAL <br />STORIES 3 <br />PERMIT FEES <br />BDRMSIFLR <br />BLDG. PERMIT <br />DWELL. <br />UNITS <br />SEPTIC <br />STATE FEE <br />PLAN REVIEW <br />a91 4-�► <br />GAR. STALLS <br />APP. DATE <br />DET. 3 <br />PENALTY <br />— <br />DOCK <br />PARK FEE <br />NON-RESID. <br />PROPOSED USE <br />SAC CHARGE <br />Occ. <br />CLASS. <br />STORIES <br />COUNCIL <br />APP. DATE <br />TOTAL DUE <br />INSPECTION REQUIRED <br />_JMTING before pour <br />RAMING rough-in <br />ULATION <br />WA L:tOARD Before Taping <br />F INA L before occupancy <br />WORK BEYOND OR WITHOUT A RE- <br />QUIRED INSPECTION WILL BE SUB- <br />JECT TO PENALTY. <br />INSPECTION HO'JRS 473 7357 <br />CALL 8 12 A.M. INSP. 1 - 4 P.M. <br />CALL 1 - 4 P.M. INSP. NEXT DAY <br />WORK REQUIRING <br />SEPARATE PERMITS <br />PLUMBING L/ <br />MECHANICAL____ <br />WELL <br />SEPTIC <br />SEWER <br />WATER <br />GRADING & FILLING <br />ELECTRICAL from State <br />COPY: WHITE -FILE GREEN -FINANCE <br />CANARY -INS#'ECTOR GOLD - RECEIPT <br />PINK-ASSE-'SOR <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- I <br />ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br />MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER -- <br />SIGNED FURTHER AGREES TO DO A .. WORKS IN STRICT COM- I <br />PLIANCE WITH ALL CITY WIF ORONO ORDINANCES AND STATE <br />OF MINNESOT BUILDI ODE QUIR EQITS. <br />T <br />Signature Date/L- <br />Approved J / Cit, of rlrono <br />