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CITY of ORO�O _ _ <br /> Building Permit PERMIT NO. 6OH� � <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT ` ^ ' c- <br /> SITE ADDRESS P� � 1 �� <br /> PROPERT ENTIFICATION NO.(PID) �` <br /> FIRE DEPARTMENT LOT BLOCK SU6DIVISION <br /> POST OFFICE NER ame) (Address) (Phone) C � <br /> � <br /> VAR. DATE ARCHITECT/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 /> WIDTH DEPTH <���"�� <br /> TYPE OF WORK N�ew_ Addition Remodel Renovate <br /> PROPOSED SETBACKS: �I-/lJ G!� �� C�� <br /> FRONT R. SIDE Q <br /> CONST.TYPE BUILDING SIZE Esti ated Construction Valuation <br /> REAR L. SIDE <br /> L. W. Ht. � ��� <br /> LAKE WETLANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION <br /> ACCESS DWELL. STORIES B 1 2 3 BLDG. PERMIT � �� <br /> UNITS � �� <br /> STATE FEE <br /> NEW EXISTING GAR. STALLS NUMBER OF BEDROOMS <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 /> `,� <br /> PENALTY _ <br /> PRIVATE EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> REMARKS: TOTAL DUE ����� <br /> ���� <br /> i 5-�- C� � -�� <br /> � � _ � � � <br /> _,---- <br /> INSPECTION REQUIRED <br /> 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 /> �❑ . . . WALL60ARD 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- SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> SEWER.............................. <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH AL CITY OF O ONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. ❑ <br /> OF MINNE TA BUILDI O QUIREMENTS. <br /> GRADING&FILLING ............... ❑ <br /> INSPECTIONS MUST BE CALLED-IN <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ �I� /�� <br /> Signat e Date � <br /> COPY:WHITEFILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT � <br /> PINK-ASSESSOR Approved � it o <br /> Brookiyn Prtg.&Adv.Co.Inc. (612)567�470 <br />