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(:ITY of ORO�Tn <br /> Building Permit PERMIT NO. 5�1i� � <br /> /_ � <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED ' (C� T � <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> / <br /> ZONING DISTRICT ��� � �t�� �� <br /> SITE ADDRESS � <br /> PROPERTY IDENTIFICATION NO.(PID) �� f � C� <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWNER (Name) (Address) (Phone) <br /> �• , . <br /> _�l � `'►. .. ' � � /�,`- G�i ��..F �- - � <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family, Commercial Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LO AREA BUILDER (Firm) (Address) (Phone) <br /> I D D E PT H l.l��C. ��' �ti �j('J" /(>(� � � —,�:_�S <br /> TYPE OF WORK New Addition Remodel Renovate <br /> P SED SETBAC S ' � � <br /> F ONT R. SID �� � � ��c '��ir-� � -�� <br /> CONST.TYPE UILDING SIZE Estimated Construction Valuation <br /> R AR <br /> `L. I/ ��,�- <br /> L. W. H t. �(_J�� <br /> LAKE LANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION ,, -•-j <br /> ACCESS DWELL. BLDG. PERMIT �'w' � `-� <br /> STORIES B 1 2 3 <br /> UNITS STATE FEE � D G� <br /> NEW EXISTING GAR.STALLS NUMBER OF BEDROOMS � i- <br /> AGENCY-APPROV. DATE q� 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 /> TOTAL DUE �'' //'�/�. �� <br /> REMARKS: t1(� <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 /> WELL ............................... ❑ <br /> . . . . . FINAL before occupancy <br /> ❑ . . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SEWER.............................. � SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> QUIRED INSPECTION WILL BE SUB- P�IANCE 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................................. ❑ <br /> Signature �ate �'���i1�� <br /> COPY:WHITE-FILE GREEN-FINANCE � <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved '�—�� ty of Orono <br /> Brooklyn Prtg.&Adv.Co.Inc. (672)561-4470 <br />