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ClTYof ORONO <br />Building Permit <br />^ • <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br />ZONING DISTRICT SITE ADDRESS 3175“ <br />PERMIT ^ 50241 <br />DATE ISSUED <br />EXPIRES________________ <br />FIRE ZONE <br />VAR. DATE <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />R.SIDE _ <br />REAR LSIDE <br />LAKE <br />/-76r' <br />WETLANDS <br />ACCESS <br />NEW EXISTING <br />AGENCY-APPROV. DATE <br />CITY <br />COUNTY <br />STATE <br />PR. EASEMENT <br />ST <br />LEGAL DESCRIPTION; PROP. ID. OH'/i'l - 2.*^ .^3 ^ ? <br />LOT BLOCK SUBDIVISION <br />OWNER (Name) (Address) <br />%n<: fix g.r <br />(Phone) <br />ARCHITECT/ENGINEER - Must Certify Multi-Family, Commercial & Industrial Construction Plans <br />CERT. NO.(Firm)(Address)(Phone) <br />BUILDER (Firm)39//COFJje (Phone) <br />TYPE OF WORK New Addition Remodel Renovate <br />f-*TX» txcVT# <br />CONST. TYPE BLDG. SIZE <br />L.W.Ht. <br />RESIDENTIAL <br />DWELL. <br />UNITS <br />STORIES B 1 2 <br />BDRMS/FLR <br />3 <br />GAR, STALLS <br />ATT. <br />DET. <br />SEPTIC <br />APP. DATE <br />NON-RESID. <br />OCC. <br />CLASS. <br />DOCK <br />PROPOSED USE <br />EST. CONST. VALUATION <br />©O#>2<DOo. <br />PERMIT FEES <br />BLDG. PERMIT <br />STATE FEE <br />PLAN REVIEW <br />PENALTY <br />PARK FEE <br />SAC CHARGE <br />3Z.SO <br />/.0€r <br />STORIES COUNCIL <br />APP. DATE TOTAL DUE 33'^° <br />REMARKS:• C^btKJ <6^ ^£AJO^AT\tl> /f^TO ^^Vcl to <br />INSPECTION REQUIRED <br />__________FOOTING before pour <br />__________FRAMING rough-in <br />__________INSULATION <br />__________WALLBOARD Before Taping <br />__________FINAL before occupancy <br />WORK BEYOND OR WITHOUT A RE­ <br />QUIRED INSPECTION WILL BE SUB­ <br />JECT TO PENALTY. <br />INSPECTION HOURS 473-7357 <br />CALLS - 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 State <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 WORKS IN STRICT COM- <br />PuiANCE WITH ALL CITY OF ORONpi^RDINANCES AND STATE <br />OF MINNESOTA BUILDING,CODBrfiEQJ/IREMENTS. <br />Signature <br />COPY: WHITE-FILE <br />CANARY-INSPECTOR <br />PINK-ASSESSOR <br />GREEN-FINANCE <br />GOLD-RECEIPT <br />Approved <br />Date 63 <br />City of Orono