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CATY of ()RONO ) <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66, CRYSTAL BAY, MN b5323 473-7357 <br />TONING DISTRICT <br />FIRE DEPARTMENT <br />POST OFFICE <br />VAR DATE <br />COND USE DATE <br />LOT AREA <br />WIDTH E H <br />PROPqv <br />C S <br />FRONE <br />REE <br />LAKE WETLANDS <br />ACCESS <br />NEW EXISTING <br />AGENCY-APPROV DATE <br />CITY <br />COUNTY <br />STATE <br />PRIVATE EASEMENT <br />F <br />PERMIT NO 5629 <br />DATE ISSUED <br />S <br />SITE ADDRESS <br />(�� <br />'�'1-D /pe/ <br />PROPERTY IDENTIFICATION NO <br />(PIDI <br />LOT BLOCK <br />SUBDIVISION <br />_ <br />OWNER (Name) <br />(Address) <br />(Phone) <br />FYI <br />!�% <br />- qVx <br />AUtHITECI /ENGINEER - Must <br />_ _L_L <br />rllfy Multi -Family, Commercial 3 Industrial Construction <br />tans <br />(Firm) <br />(Address) <br />(Phone) <br />BUILDER IF inns IAJdressl <br />j i - / Q/ Ir <br />E OF WO '—New') Addlt,on R <br />r <br />(Phone! <br />Renovate <br />CONST TYPE <br />BUILDING SIZE a <br />Estimated CnnSIrUCtion Valuation <br />L W .X / H t _ <br />�j <br />C' t <br />15.,'r� <br />OCCUPANCY <br />PERMIT FEES <br />CLASSIFICATION <br />BLDG. PERMIT <br />6v <br />��/�• '�' <br />DWELL <br />STORIES B i 2 A <br />UNITS <br />STATE FEE <br />PLAN REVIEW <br />GAR STALLS <br />ATT <br />NUMBER OF BEDROOMS <br />_- <br />SAC CHARGE, <br />s <br />SEPTIC <br />APP DATE <br />SEWcR U%17 <br />PROPOSED <br />USE <br />_. . <br />PARK FEE <br />PENALTY <br />COUNCIL <br />APP DATEE� <br />OTHER <br />' C) T A t 1 ' l, <br />- <br />- -► -U 01re zw <br />WORK REUUIRINt, <br />ACKNOWLEDGEMENT <br />CTION REOUIRLI' <br />:_4�S_pl <br />.. FOOTING before pI„., <br />SFPARATE PERMITS <br />704E UNDERSIGNED HEQ. <br />REBY REUUE,S PERMISSIOn4 TO MAKE <br />Pr_. FRAMING rough n <br />PLUMINNG <br />lei <br />THE RE AL IMPROVEMENTS SPECIFIED AND DECLARES <br />INSULATION <br />MECHANICAL <br />Ad", <br />UNDER PENALTY OF LAW ACKNQWLEDGEMENT ANO ACCEPT <br />WALL80AAD Oetorr lap-ny <br />WEiI <br />0 <br />AMCE OF All INFORMA1.0% CONDITIONS AND REQUIRE <br />.. , . .. FINAL oelare ot:cupency <br />C ... SITE INSPECTION <br />SE Pi IC <br />MINIS FIEPREEENTEO ON THIS LNX7UMENT THE UNDER <br />WORK BEYOND OR WITHOUT A RE <br />SEWER <br />SIGNED FURTHER A(iREES TO DO ALL WORK IN STRICT CC" <br />OUIREU INSPECTION WILL dL SL18 <br />WATER <br />0 <br />PRANCE MATH A(L CITY OF OW)%O (WrH%ANCES AN[) STA*F <br />JECT TO PENALTY <br />sRADNWi i f II 1 IN(, <br />T CN h E A (;000)E RE ULNAE ME N!g <br />v31 <br />INSPECTIONS MUST BE CALLED -IN' <br />24 HOURS IN ADVANCE <br />FIRE <br />❑ <br />,.yna6,r.- CuII� <br />COPY WNITf F It E GR! f N I' �NANr ! , _ - <br />CANARY INSNE C TOH (i{JI D RE (.E IPI <br />Plhtl ASSESi()N <br />-'� rw <br />�� <br />