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APPLICATION FOR BUILDING PERMIT <br />AND CERTIFICATE OF OCCUPANCY <br />VILLAGE OF ORONO, MINNESOTA <br />DIRECTIONS: 7PERMiT NUMBER <br />SPACES NUMBERED 1 THRU 13 MUST BE FI'AED IN <br />BEFORE PERMIT IS ISSUED (Please Print or Type) <br />;C rr 46 <br />1. SITE ADDRESS 2. DATE <br />3. LEGAL DESCRIPTION <br />PLAT NUMBER PARCEL NUMBER <br />4. OWNER (Nome) (Addnn) <br />�u Ie�rf°lt!.h TF <br />3. ARCHITECT (Nome)— (Address) <br />0. BUIlOER �..+ (Name) �nu) <br />7—TYPE of WORRiX451–A <br />NEW CONSTRUCTION WOO" ALTERATIONS ❑ ADDITION ❑ <br />FINISH BASEMENT ❑ <br />E SIZE OF STRUCTURE <br />(Height) 1Wick1p) <br />I1. COMPLETION DATE <br />PORCH ❑ GARAGE ❑ REROOF ❑ <br />A— r. NO. OF STORIES <br />y <br />12 PROPERTY DIMENSIONS <br />WIDTH DEPTH <br />11, TYPE O CONSTRUCTION 13. PROPERTY AREA <br />— &IyXle _ _ SO. FT. <br />17. FRONT YARD Ill. REAR YARD <br />FT. -1--------- --- ---- —1 PT.-- . _ <br />20. FLOOR ARIA AMORTIONRIAM <br />- — (Tel. No.) <br />iTel. No.) <br />;Tel. No; <br />FINISH ATTIC ❑ <br />RESIDE ❑ misc.- <br />10 ESTIMATED COST <br />c- In -en <br />13. NO. OF FAMILIES (IF Applicoble) <br />IA. LOT AREA PER FAMILY <br />SQ. FT. — <br />19. SIDE YARDS <br />(I)- PT (2) _ R. R. (1 m 2) FT <br />PERMIT FEE <br />PLAN CHECK FEE <br />PEF:ALTY FEE <br />TOTAL FIE <br />ZONING DISTRICT <br />FIRE ZONE <br />AGGREGATE FLOOR AREA <br />FLOOR AREA RATIO <br />OFFSTREET PARKING <br />SPACES REQ. - <br />SPACES ON PLAN <br />LOADING BERTHS <br />NUMBER REO. <br />NUMBER PROVIDED _ <br />SIZE OF EACH,-----.--- <br />NUMBER <br />ACH.__-_—.___ <br />NUMBER OF OCCUPANTS OR SEATS <br />OCCUPANTS <br />SEATS <br />MAT/RIAI /Ili WITH APP1lCATION <br />SOIL TESTS ❑ <br />PILING LOGS O <br />PLANS 6 SPECS. ❑ SETS <br />USE. <br />AREA <br />SURVEY ❑ COPIES <br />1 <br />PROPOSED GRADE FOUNDATION <br />IN RELATION TO CURB OR CROWN <br />OF STREETe <br />AGOREGATE FLOGS AREA <br />So. <br />PT. <br />ACKNOWLEDGMENT AND SIGNATURE: <br />TLe andersi.Ened hereln• represents upon all of thepenalties of law, for the <br />purpcx. �4 induce.; the Village of Orono to take the action herein rc Nested, that <br />all statements herein are true and that all work herein nicutioncY1 wiU he done in <br />accordiuce with the ordinance of the Village of Orono, the State c fillnesota, <br />.110 11 1 n of th ui in¢ Dc artment. // /// <br />/I i VA <br />IL <br />f14N CARR F <br />CERTIFICATE Of OCCUPANCY ISSUED <br />DATE BY <br />