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C I ;l j �l DA���1�I�� P E R M I T �� � 5 4 0 0 � <br /> Building Permit - <br /> DATE ISSUED $ vZY`�`� <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY EXPIRES <br /> P.O. BOX 66, CRYSI"AL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT SITE ADDRESS /�,k� �.5��,�L✓o✓t� <br /> LEGAL DESCRIPTION: PROP. ID. �7//7d> �/L`�L"�� y <br /> LOT BLOCK SUBDIVISION <br /> FIRE ZONE <br /> WNER (Name) (Address) (Phone) <br /> VAR. DATE " i � /f����: l� ���� S .�� u <br /> ARCHITECT/ENGINEER — Must Certify Multi-Family, Commercial & Industrial Construction Plans <br /> COND. � DATE � ERT.NO. <br /> (Firm) (Address) (Phone) <br /> LOT A <br /> WI \ ED'�H BUILDER (Firm) (Address) (Phone) <br /> �c�N�i�'vG <br /> PROPOS� TBACKS <br /> FRON R.SIDE TYPE OF WORK New Addition Remodel �Renovate� <br /> RE R LSIDE ��iv�r��f= <br /> CONST. TYPE BLDG.SIZE EST.CONST. VALUATION <br /> LAKE WETLANDS <br /> �. w. Ht. .� /. �S l� <br /> ACCESS RESIDENTIA STORIES B 1 2 3 PERMIT FEES <br /> BLDG. PERMIT v��• U(�� <br /> NEW EXISTING DWELL. BDRMS/FLR <br /> AGENCY-APPROV. DATE UNITS STATE FEE I - 6�� <br /> CITY GAR.STALLS SEPTIC <br /> ATT. APP. DATE PLAN REVIEW <br /> COUNTY �ET. PENALTY '�, C� G <br /> DOCK <br /> STATE NON-RESID. PROPOSED USE PARK FEE <br /> PR. EASEMENT OCC. <br /> SAC CHARGE <br /> C LASS. <br /> STORIES COUNCIL /''� <br /> APP. DATE TOTAL DUE �-f� ���J <br /> REMARKS: � H I NC��.�S �"UT f�-���}�� =YJ CN f' ���!-fc� �—.� 5 -�r��4/�� I <br /> �� 11n �J S 1 (,1 S �C �/�� 1" t � N � 'T rI i►'�-�L� C--iQ�'� <br /> ��o�� �S�-r�Pc� ���1� ���� <br /> INSPECTION REQUIRED WORK REQUIRING ACKNnWLEDGE!!/IENT <br /> FOOTING before pour SEPARATE PERMITS <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> FRAMING rough-in <br /> INSULATION PLUMBING THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES <br /> WALLBOARD Before Taping MECHANICAL UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> WELL ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> F I N A L before occupancy <br /> SEPTIC <br /> MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER— <br /> WORK BEYOND OR WITHOUT A RE- SEWER <br /> QUIRED INSPECTION WILL BE SUB- SIGNED FURTHER AGREES TO DO A�L WORKS IN STRICT COM- <br /> WATER <br /> JECT TO PENALTY, PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STAT' <br /> GRADING& FILLING <br /> INSPECTION HOURS 473-7357 OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> CALL 8 - 12 A.M. INSP. 1 -4 P.M. <br /> CALL 1 - 4 P.M. INSP. NEXT DAY ELECTRICAL from State �� <br /> � <br /> Signature � Date �� <br /> COPY: WHITE—FILE GREEN—FINANCE <br /> CANARY—INSPECTOR GOLD—RECEIPT l� ( ,+, <br /> PINK—ASSESSOR Approved _ � �� .�G'TmC� \��%� Cinr of Orom <br />