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CITY of ORO1TO _ _ <br /> Buildin Permit PERMIT NO. 6149 <br /> g <br /> AND APPUCATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED ' � <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT '� "')/� �/� � � <br /> SITE ADDRESS Z�' f <br /> PROPERTY IDENTIFICATION NO.(PID) c D—�,���' � -�/ � �'� � <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE O NER ` �{Name) � (Address) (Phone) <br /> y/��` ✓ ��" F� � <br /> VAR. DATE CHITECT/ENGINEER - Must Certify Multi-Family,Commercial& Industrial Construction Plans <br /> �� (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> ��''t„� <br /> WIDTH DEPTH <br /> TYPE OF WORK New Addition Remodel Renovat�. <br /> PROPOSED SETBACKS: � l � ` - � <br /> FRONT R. SIDE Q ' t i <br /> CONST.TYPE BUILDING SIZE Estimated Co uction Valuat n <br /> REAR L. SIDE <br /> .�i � �'��_ <br /> L. W. H t. I <br /> LAKE WETLANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION ! �) �i <br /> BLDG. PERMIT ' �`Y' "� � <br /> ACCESS DWELL. STORIES B 1 2 3 <br /> NEW EXISTING UNITS STATE FEE ,� / -� <br /> 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 /> " f- ,( ��o �- , TOTAL DUE � � � .�. �� <br /> REMARKS: ��' � /� � r ��� �� '� r..��_ <br /> � - � �.H <br /> : � <br /> INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT <br /> SEPARATE PERMITS THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> �❑ FOOTING before pour <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 /> . . . . . <br /> WELL ............................... <br /> . . . . . FINAL before occupancy <br /> . . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> SEWER.............................. <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............. ❑ <br /> OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> GRADING&FILLING ............... ❑ , <br /> INSPECTIONS MUST BE CALLED-IN � <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ � p � <br /> Signature b^�-'�l— Date <br /> COPY:WHITE-FILE GREEN-FINANCE ,�-i <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PWK-ASSESSOR Approved =�ity of Orono <br /> Biooklyn Prtg.&Adv.Co.Inc. (612)561-0470 � <br />