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CITY of ORO�TO <br /> Building Permit PERMIT NO. 5829 ' <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED /�`'�O � <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT n <br /> - -" �- SITE ADDRESS � .��f; � C�JC CC Xl� � <br /> �� � PROPERTY IDENTIFICATION NO.(PID) <br /> FIRE DEPARTMENT /1L` LOT- � BLOCK SU6DIVISION � ^^ � � � � <br /> r �z ��� �,� _ � � � �_�,� � - _ <br /> POST OFFICE \�NER (Name) (Address) Phone) <br /> � <br /> (,�1-�-�,Z � <br /> �� � �' � � , � �.. :� r_� C�-�� ^ r� � � ���1 . �%��:���J� � <br /> VAR. DATE ARCHITECT/ENGINEER- Must Cer fy Multi-F ily, Commercial& Industri Construction Plans <br /> � (Firm) (A ress) 5-'��._��,� hone) <br /> COND. USE DATE 'i '� , � <br /> C�, _ � �� � � ��. �� � ,-�i ��.� <br /> LOT AREA BUILDER (Fir (Add ess) (Fho ) � <br /> S �- L I y�5- �y��� <br /> WIDTH D�PT l C �J�` '��c ^ C� � � S� � �_.L L l <br /> '���� TY EOF WORK w Addition R model Renovat` <br /> PROPOSED SETBACKS: ,�¢�� ' ^� / <br /> FFiQL1T R.SIDE__ '✓ 7 `> � � 7^ C'( �7�`� ' <br /> CO ST.TYPE ILDING SIZE Es mated Construction Valuation <br /> REAR L. SIDE � <br /> � �� I � <br /> LAKE � � WETLANDS L. . � � W. < �� Ht't� � ������� C��._�C�� � <br /> , OCC PANCY PERMIT FEES <br /> '— � � � ��j � CLA SIFICATION �. <br /> °��- r�� /S� � c �c DWE L STORIES B � �;; BLDG. PERMIT ����' �'�� <br /> . �1;�.� _. �_ UNIT �'. '` <br /> STATE FEE O�' <br /> NEW EXISTING GAR. TALLS NUMBER Of�BEDROOM <br /> AGENCY-APPROV. DATE . s �� � <br /> � ATT. � PLAN REVIEW � �I � <br /> CITY � DET. t��� SEPTIC C� _ <br /> APP. DATE '� <br /> � ��-'� �'� SAC CHARGE � f <br /> COUNTY PROPO ED USE ', SEWER UNIT <br /> i <br /> STATE �4 � � PARK FEE _ <br /> ; C.����:� ��' =1 C�-'l; <br /> PENALTY <br /> P VATE EASEMEI�T OUNCI C-?� L�� � /(p �_�� __��-`3 <br /> � P P. DAT '" (,l.t . C. C�.� ,� �. �- OTH E R --- <br /> TOTAL DUE �� � C' � <br /> REMARKS: �.� <br /> W RK REQUIRING ACKNOWLEDGEMENT <br /> INSPECTION REQUIRED S PARATE PERMITS <br /> . . . . FOOTING before pou THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> . . . . . . FRAMING rough-in P UMBING ......................... THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES <br /> „ . . . . . . INSULATION ECHANICAL.......................� 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................................. ❑ <br /> Signature Date <br /> COPY:WHITE-FI�E GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT —�7� <br /> PINK-ASSESSOR Approved � ti <br /> �"Ci of Orono <br /> Brooklyn Prtg.&Adv.Co.Inc. (612)561A470 <br />