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CITY of ORO)NO PERMIT 4404 <br />Buildin Permit <br />a DATE ISSUED <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY EXPIRES <br />P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br />ZONING DISTRICT SITE ADDRESS <br />LEGAL DESCRIPTION: PROP. ID. - <br />LOT ? BLOCK __ z_ SUBDIVISION <br />FIRE ZONE <br />VAR.DATE <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />FRONT 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 />WNER <br />N e)ddress) <br />1 <br />—) <br />(Phone) <br />ARCHI ECT/EN INEER —Mint Ce <br />fy Multi -Family, Commercial & Industrial Construction Plans <br />ERT.NO. <br />(Firm) <br />(Address) <br />(Phone) <br />—41&A4-- <br />- <br />-4 <br />a�z� <br />5,17949.e 7 <br />BUILDER <br />V (Firm) <br />(Address) <br />(Phone) <br />TYPE OF WORK ew <br />Addition Remodel <br />Renovate <br />CONST. TYPE <br />BLDG. SIZE <br />EST. CONST. VALUATION <br />L. <br />W. <br />Ht.1000100 <br />�y <br />RESIDENTIAL <br />STORIES B <br />1 <br />2 3 <br />PERMIT FEES <br />BDRMS/FLR <br />BLDG. PERMIT <br />✓fS <br />DWELL. <br />UNITS <br />STATE FEET <br />PLAN REVIEW <br />GAR. STALLS <br />SEPTIC <br />ATT. )e <br />APP. DATE <br />DET. <br />PENALTY <br />DOCK <br />PARK FEE <br />NON-RESID. <br />PROPOSED USE <br />SAC CHARGE <br />S <br />OCC <br />CLASS. <br />STORIES <br />COUNCIL <br />APP. DATE <br />TOTAL DUE <br />y <br />1 J•Sa?, ,0U <br />INSPECTREQUIREDEQUIRED <br />TING before pour <br />_ l�R/ AING rough -in <br />U LAT IO N <br />:_::A�WA OAR Before Taping <br />FINAL before occupancy <br />WORK BEYOND OR WITHOUT A SE. <br />QUIRED INSPECTION WILL BE SUB. <br />JECT TO PENALTY, <br />INSPECTION HOURS 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 <br />MECHANICAL <br />WELL <br />SEPTIC <br />SEWER <br />WATER <br />GRADING & FILLING <br />ELECTRICAL from Stab <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 R <br />EES TO DiE <br />WORKS IN STRICT COM- <br />PLIANCE WITHJAIYILITY OF ORORDINANCES AND STATE <br />OF MINNESOTDING CODE IREMENTS. <br />Signature <br />COPY: WHITE —FILE GREEN —FINANCE <br />CANARY —INSPECTOR GOLD —RECEIPT <br />PINK —ASSESSOR <br />Approved <br />City of Orono <br />