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<br />."�l�0 APPLtCATiON FOR CERTIFICATE OF OCCUPA�JCY EXPiRES -
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<br />�'.0. B�X 6B, CRYSTAL BAY, MN 55323 473-7357 ��
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<br /> VAR.OATE Z. � q C'� F�X�f��f.Fzr �T K�1 . � / —LY� �'� ' �t"�
<br /> ARCHITECT/ENGINFER — Must Certify Muiti Family,Commrrcial & Indwtria!Co�struction Pt�s �`
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<br /> (Firm) (Address) - (Phone) �,
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<br /> NEY� EXISTING DWELI. BDAM:;iF�R
<br /> PGENCY-Al�PROV.OATE uH�Ts STATE FEE ` � j`
<br /> C�TM GAR.57ALLS SEP71C �7 PLAN REVIE'N �
<br /> ATT. Z APP.DA�E S'I�— / `
<br /> COUNTY DE7. PENAL"i Y __
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<br /> PARK FEE � + �'
<br /> STATE NON�RESID. PROPOSFDUSE � u
<br /> SAC CHAHGE yZ_S� K
<br /> PR. EASEMENT uCC. � �
<br /> c 1A55. �
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<br /> STORIES COUNCIL w 3 `
<br /> APP.DA7E 70TAL DUE �� �3 � '�
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<br /> IidSPECTION RFQU(RED WORK REQUiRING �+Cf{('i:t`�'���v��"ri�:�dT
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<br /> FOOTII'�G bJfae pour SEPl1fiATE PERf�91TS THE UNDERSIGNE(�HEREBY REQUESTS PI:RMIS5IGN TO k1i:riE � ,
<br /> FRAMING rouph•i� pLUMBING — 7HE REAL 161PROVEb1ENTS SPECIFIEU, ANO D�CLARj:S +�
<br /> INSULATION — —
<br /> WALLBOARD Befae Tapin£ MECHANICAL — UNOER PENAI.'Y OF LAW ACKNOWI.EDGEMENT AND ACCEi'T• �
<br /> WEII .-- ANCE OF All. WFOR�IATlON, COl�OtT10145 AND REnUIFE� *'
<br /> F INAL t�fon oauW�+�Y `
<br /> SEPTlC MENTS REPfiESENTED ON THIS DOCUr.1ENT. TME U!'1�ER--- ,s ` ',;
<br /> WORK BEYOND OR WITHOUT A RE- S�Yr��" — SIGNED FURTHER AGREES TO DO A�L 1NORKS Ilv Si'RICT CCr'•- � `"
<br /> QUIRED iN$PECTION WIL� BE SUB• ��
<br /> JECT TO PENALTY, �;RqDING&FILLING�_ PUANCE WITH All CITY OF OROhO OfiDinANCES:�"iG S7 b�E � �'
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<br /> INSPECTION HOUFS 47S•7357 pF M�NNE BUIIDI G CODE REnUIftEMENTS. 4�,
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