HomeMy WebLinkAbout10-31-1986 Building Permit Application Pg 1 of 2CITY of OKONO
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357
PERMIT NO. 6215'
Jo -31-21^DATE ISSUED
ZON^ DISTRICT
FIRE DEPARTM^T
POST OFFICE
C • L*
VAR. DATE
COND. USE DATE
LOT AREA _ ^ 1
WIDTH , DEPTH
koo't- /i,d'Jz
PROPOSED SETBACKS: ^ r\ i i
REAR L. SIDE
''5d,0' SOO'-^
LAKE WETLANDS
ACCESS
.EXISTING
aIgeu C y-approv . date
COUNTY
STATE
PRIVATE EASEMENT
SITE ADDRESS.
PROPERTY IDENTIFICATION NO. (PID)
LOT____I______BLOCK i
HK^dcjl LOg..,.
Jtn ^
SUBDIVISION /^r>n /^l4^r\
(Address)(Phone)OWNER (Name)
ARCHITEC^/ENGINEER “ Musi cierTi^^ Mulli-Family. Commercial & Industrial Construction Plans
(Phone)(Firm)
K‘C-IwiajJI pk.
(Address)
BUILDER (Firm) ' (Address)
l~^n(ffmar\C P,Cfs4-. /-^nc/-A.K.<L Wn
(Phone). ,^7 3-a^
TYPE OF WORK /^ew) Addition^
&S.
Remodel Renovate
CONST. TYPE BUILDING SIZE
W.Ht
OCCUPANCY
CLASSIFICATION
DWELL.
UNITS
STORIES B 1 2 3
GAR. STALLS
ATT.
DET.
NUMBER OF BEDROOMS
SEPTIC .
APP. DATE / O'^O' y(o
PROPOSED USE
COUNCIL
APR DATE
REMARKS:
Estimated Construction Valuation
1^X000.
BLDG. PERMIT
STATE FEE
PLAN REVIEW
SAC CHARGE
SEWER UNIT
PARK FEE
PENALTY
OTHER
PERMIT FEES
9
M7iT.- oo
TOTAL DUE IS 33. oo
INSPECTION REOUIRED
.........FOOTING bcloro pour
WORK REQUIRING
SEPARATE PERMITS
........FRAMING rough-in PLUMBING............................□
&..........INSULATION MECHANICAL.........................□
&...........WALLBOARD before taping
WELL..................................n>3...........FINAL before occupancy
^...........SITE INSPECTION SEPTIC...................................□
WORK BEYOND OR WITHOUT A RESEWER...................................□
OUIRED INSPECTION WILL BE SUBWATER.................................
GRADING & FILLING...........
nJECT TO PENALTY...□
INSPECTIONS MUST BE CALLED-IN
24 HOURS IN ADVANCE.FIRE.......................................□
COPY: WHITE-FILE
CANARY-INSPECTOR
PINK-ASSESSOR
firooVlyn PM9. & Atfv. Co Inc. 1613) 56M470
GREEN-FINANCE
GOLD-RECEIPT
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES
UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT
ANCE Of ALL INFORMATION. CONDITIONS AND REQUIRE
MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER
SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
OF MINNESOTA BUILDING/)ODE REQUIREMENTS
Signature.
r/
.Dale
Approved .City of Orono