HomeMy WebLinkAbout1975-05-22 Application for Building Permit, New ResidenceAPn,ICATinN FOR BUILDING (ALTERATION 5 ADDITION) PERMIT
VILLAGE OF • M.
(Xner's Name
Address ^121 ._ _ _
/ /
Builder's Name
Address_ _ _
Phone i
$ /
r *
Nb. 37*-' street (?^SCO
- Block 4 Addition QA'TCC} UiaJitH,
Location of Lot: Comer Lot Inside Lot 5
AILMLot Dimensions: Front f€0 Rear fl4>^ Side tyg
Structure Setbacks: Front Rear /Sf * Side /Z
Wetlands: Yes No ^ /jrea if anv
Lakeshore Lot
Stoc ,
Aaaa
Lakeshore /Z ^!
Special **rovisions: Variance: Yes
Date Approved
Lot Changes: I
Type:
Comb.Div.Date
Applicant attach to this font two Certificate of Survey of lot and proposed building
location dmwn on these surveys. Also attach two sets of building plans.
^”*P®ction before permit is issued. Residential - 2 davs. Com-
flircial ar^ liuiustrial - 2 weeks. Plan Check Fee sust be submitted with application.
Plan Check Fee - Residential - SOI Building Permit Fee
Conaercial % IndustrUl • 6SI Building Penait Fee
Description of Building:
To be used as: Htf^S
Dimensions: Front ^ Depth Hei^t
Sq. Ft. /Z ^Dom*J
Cu. Ft.
FFont fpth Height
Sq. Ft.
lypi' of Construction
C . Ft.
Estimrited Cost
FfUmlted Complotion Dote
The layersignoil heTeby imkes application for a building nermit for the work as herein
*P*cified, agreeing to iU> all work In strict accordance with the ordinances of the
Village of Orono and rulings of the State Department of Fkiildii^ Hereby declares
tnMi All facts and representations statCNj In this appllCiitiQfi are true and correct.
Dale:
T
signatuff
^rmit Fee Plan Qieck Fee