HomeMy WebLinkAbout1969-10-31 Application for Permit, New ResidentialAPPLICATION FOR BUILDING PERMIT
AND CERTIFICATE OF OCCUPANCY
VILLAGE OF ORONO, MINNESOTA
DIRECTIONS: PERMIT NUMBER
SPACES NUMBERED 1 THRU 13 MUST BE FI�LEO IN
BEFORE PERMIT IS ISSUED (Please Print or Type) I
1. SITZ ADDRESS J6
2. DATE
3. LEGAL DESCRIPTION
6T l�- I3�
h-1 1 1,yH r %a !v k A
PLAT NUMBER
4. OWNER/(home)
v
5. ARCHITECT (Name)
6. BUILDER (Name)
7. TYPE OF WORK
b 1?0N6 \/'/LGA0P.
PARCEL NUMBER
�� �(A�ddress) (Tel. No.)
: �'Ll.J
(Tel. No.)
(Tel. No.)
NEW CONSTRUCTION O ALTERATIONS O ADDITION O FINISH ATTIC ❑
FINISH BASEMENT O PORCH ❑ GARAGE O REROOF ❑ RESIDE ❑ MISC.
B. SIZE OF STRUCTURE
(Helpht) (Width) (Depth)
11. COMPLETION DATE
14. TYPE OF CONSTRUCTION
17. FRONT YARD
FT.
9. NO. OF STORIES
12. PROPERTY DIMENSIONS
WIDTH �� DEPTH
15. PROPER A�
SQ. FT. `/_ C In
18. REAR YARD
FT.
10. ESTIMATED COST
17. NO. OF FAMILIES (If Applicable)
16. LOT AREA PER FAMILY
SQ. FT. _
19. SIDE YARDS
(1) FT (2) FT. ET. 0 x 2) FT.
20. FLOOR AREA APPORTIONMENT
USE. AREA
SQ. FT.
e/'
SQ. FT.
SQ. FT.
AGGREGATE FLOOR AREA SQ. FT.
ACKNOWLEDGMENT'; AND SIGNATURE:
The undersigned hereby represents upon all of the penalties of lain, for the
purpose of inducing the Village of Orono to take.thc action hcrcin requested, that
all Statements licrcin are true and that all work hcrcin mentioned will be done in
accordance with the ordinance of the Village of Orono, the State of illinnesota,
and rulings of the Building Department.
�k 13 _a�o_ Sr o 4 ,S �- N
&NATURE APPROVED
PERMIT FEE
PLAN CHECK FEE
PENALTY FEE
TOTAL FEE
ZONING DISTRICT
FIRE ZONE
AGGREGATE' FLOOR AREA
FLOOR AREA RATIO
OFFSTREET PARKING
SPACES REQ.
SPACES ON PLAN
LOADING BERTHS
NUMBER REQ.
NUMBER PROVIDED
SIZE OF EACH
NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
MATERIAL FILED WITH APPLICATION
SOIL TESTS O
PILING LOCI ❑
PLANS & SPECS. O SETS
SURVEY O COPIES
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREETt
CERTIFICATE OF OCCUPANCY ISSUED
DATE BY