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C ITY of OI�(�NO _ _ : . <br /> Building Permit PER""'T "°. 571� ' <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED � � <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT <br /> SITE ADDRESS �S D C �� � � <br /> PROPERTY IDENTIFICATION NO.(PID) __ V� `I I 7 '�� O I (} <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWNER (Name) (Address) (Phone) <br /> !1►' P_ �e s - <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Fa ily,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> � <br /> WIDT EPTH SS . <br /> TYPE OF WORK New Addition Remodel Renovate <br /> PRO SE S ACKS: � � � <br /> FRON R.SIDE f� G 1 1 <br /> CONST.TYPE BUILDING SIZE Estimated Construction Valuation <br /> REAR L. SIDE <br /> � � Od <br /> LAKE WETLAN �' O W �v Ht. 8�b� � <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION /� A �O <br /> DWELL. BLDG. PERMIT ��'Q <br /> AC ESS STORIES B 1 2 3 <br /> UNITS STATE FEE _�'�' '�O <br /> N EXISTING GAR.STALLS NUMBER OF BEDROOMS <br /> AGENCY-APPROV. DATE q�J. 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 /Q/, �� <br /> REMARKS: ��� <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 /> ❑ . . . . ..WALLBOARO before taping ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> FINAL before occupancy WELL............................ ❑ <br /> .. . . .. <br /> ... <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 WI�L BE SUB- � PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. <br /> OF MINNESOTA BUIL ING CODE REQUIREMENTS. <br /> GRADING 8 FILLING ............... ❑ C, <br /> INSPECTIONS MUST BE CALLED-IN <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ � �/' C�— <br /> Signature Date �� <br /> COPY:WHITE-FILE GREEN-FINANCE � ��- <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved � City of Orono <br /> Brooklyn Png.&Adv.Co.Inc. (8121 561�470 <br />