HomeMy WebLinkAbout1979-09-19 Permit, Dock #4092CITYofCHIOXO
Building: Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66. CRYSTAL BAY, MN 55323
20MINQ DISTRICT
FIRE ZONE
VAR. DATE
COND. USE DATE
LOT AREA
WIDTH DEPTH
PROPOSED SETBACKS
FRONT R.SlOE
REAR L.SIDE
LAKE WETLANDS
ACCESS
NEW EXISTING
AGENCY-APPROV. DATE
CITY
COUNTY
STATE
PR. EASEMENT
4737357
SITE ADDRESS.
LEGAL DESCRIPTION; PROP. ID.
PERMIT N9 . 4093
DATE ISSUED. 7-
EXPIRES__________________
3WNER (Name) (Address) (Phone)
LI A-V/ A ^
ARCHITECT/ENGINEER - Must Certi^ Multi-Family, Commercial & Industrial Construction Plans
:ertno
(Fifm) (Address) (Phone)
BUILDER (Firm) (Address) (Phone)
TYPE OF W()RK Addition Remodel Renovate
CONST TYPE BLDG. SIZE
u hl
EST CONST, VALUATION
aao *
RESIDENTIAL STORIES B I 2 3
BDRMS/FLR
PERMIT FEES
BLOG. PERMIT /d . OC
DWELL.
UNITS STATE FEE
GAR STALLS
ATT
OET.
SEPTIC
APP DATE PLAN REVIEW
DOCK ^ 'S* / / /d X"
PENALTY
PARK FEENON-RESIO.PROPOSED USE
SAC CHARGEocc.
CLASS.
STORIES COUNCIL
APP. DATE TOTAL DUE /d,
REMARKS;
INSPECTION REQUIRED
. FOOTING before poui
. FRAMING rough'In
. INSULATION
. WALLBOARD Before Taping
. FlNALbeforeoccupeiKV
WORK BEYOND OR WITHOUT A RE-
QUIREO INSPECTION WILL BE SUB
JECT TO PENALTY.
INSPECTION HOURS 473-7357
CALL 8 • 12 A M. INSP. 1 • 4 P.M.
CALL 1 • 4 P.M. INSP. NEXT DAY
WOP«< REOUIRING
SEPARATE PERMITS
PLUMBING __
MECHANICAL
WELL ______
SEPTIC____________
SEWER____________
WATER ___________
GRADING & FILLING.
electrical from Slate
COPY: WHITE-FILE
CANARY - INSPECTOR
PINK-ASSESSOR
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 THF UNDER
SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
OF MIfitMSSQTA BUliJJING COQE REQUIREMENTS.
Approved ..City of Orono