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CITY of ORONO <br /> Building Permit PERMIT NO. 57981 <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING <br /> ISTRICT" �e <br /> l� SITE ADDRESS <br /> PROPERTY IDENTIFICATION NO.(PID) — — a <br /> FIRE EPARTMENTLOT BLOCK SUBDIVISION 06 V <br /> POST OFFICE OWNER (Name) (Address) q-773007(Phone) <br /> �CO "1J, <br /> VAR. DATEARCHITECT/ENGINEER- Must Certify M Iti-Family,Commercial& Industrial Construction tans <br /> (Firm) (Address) 40 _ �°vPhone) <br /> COND. USE DATE �(� �I ( s <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH DEPTH <br /> s- 90 <br /> ®$ TYPE OF WORK _New__,' Additic n Remodel Renovate <br /> PROPOSED SETBACKS: <br /> FR T R.SIDE �� <br /> CONST.TYPE BUILDING SIZE <br /> REAR-,,) ��SIDE Estimated Construction Valuation <br /> i <br /> L. �o W. H <br /> LAKE WETLANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION <br /> ACCESS DWELL. STORIES B 1 3 BLDG. PERMIT <br /> UNITS STATE FEE C�?nen <br /> NEW EXI �N _ GAR.STALLS NUMBER OF BEDROOMS // , / <br /> AGENCY APP ATT. , —o� rlo( t � PLAN REVIEW & / `7 <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: <br /> IN PECTION 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 /> .....WALLBOARD before taping <br /> WELL............................. ❑ AN E OF ALL INFORMATIO COND�LTj 42 p�� ,REC�lU11iE_ <br /> ... FINAL before occupancy " _/ vvf.CCOO1�lTcerjR /IL1U <br /> ❑ ......SITE INSPECTION SEPTIC.............................rFJ4 ME TS REPRESENTED ON THIS DOCUMENT THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SEWER.............................. ❑ SIG ED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> QUIRED INSPECTION WILL BE SUB PLI NCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. ❑ <br /> GRADING&FILLING ............... ❑ <br /> OF INNES TA BUILDING CODE REQUIREMENTS. <br /> INSPECTIONS MUST BE CALLED-IN � <br /> 24 HOURS IN ADVANCE. FIRE ................................ ❑ U/71 �� <br /> 16 Sign ture Date <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved I of Orono <br /> Brooklyn Mg.&Adv.Co.Inc. (6121661-4470 <br />