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CITY of ORONO _ _ <br /> Buildin Permit PERMIT NO. 59H4 <br /> g <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED ��� ��J'�' <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT L� �� Q �f <br /> SITE ADDRESS � / �� � ���C' Y � �`- ' � <br /> PROPERTY IDENTIFICATION NO.(PID) �f/7'� � � �/ G�pC) �/ <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWNER (Name) (Address) (Phone) <br /> , �I c,�.��`�r � <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Mu�ti-Family,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH DEPTH �` �t'// �`/�� - <br /> TYPE OF WORK New Addition Remodel enovate <br /> PR PO SETBACKS/� � ` <br /> FR; T R. SID U �� �/(�- , � L� <br /> CONST.TYPE BUILDING SIZE timated Construct�n y luation <br /> RE i' I � <br /> t 1 � <br /> L. W. H t. <br /> LAK WETLANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION �� �� <br /> ACC S DWELL. STORIES g 1 2 3 BLDG. PERMIT <br /> UNITS � <br /> STATE FEE <br /> NEW EXISTING GAR. STALLS NUMBER OF BEDROOMS <br /> AGENCY-APPROV. DATE ATT. PLAN REVIEW <br /> CITY DET. SEPTIC <br /> APP. DATE SAC CHARGE <br /> COUNTY PROPOSED USE SEWER UNIT <br /> STATE PARK FEE <br /> PENALTY �� � `� <br /> PRIVATE EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> / � .�i� � � ����`/ ,�.� TOTAL DUE ��� � <br /> REMARKS: f �=K.�f �L., L�:l��L , �--� D � <br /> �I� a�� vk oQ�--� ����/ IX�Q�PC'�� <br /> � <br /> WORK REQUIRING ACKNOWLEDGEMENT <br /> INSPECTION REQUIRED SEPARATE PERMITS <br /> ❑ . . . . . . FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> ❑ . . . . . . FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES <br /> ❑ . . . . . . INSULATION MECHANICAL....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> ❑ WALLBOARD before taping ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> FINAL before occupancy WELL......... ❑ <br /> � . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SEWER.............................. � SIGNED FURTNER AGREES TO DO ALL WORK IN STRICT COM- <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. ❑ <br /> GRADING&FILLING ............... ❑ <br /> OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> INSPECTIONS MUST BE CALLED-IN <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ � , <br /> Signature �.� � � �L.�lti�pate 1�< �P�� <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved City of Orono <br /> Brooklyn Prtg.&Adv.Co.Ina (612)561�470 <br />