HomeMy WebLinkAbout1969-06-23 Permit, Certify Buildable LotAPPLICATION FOR BUILDING PERMIT
AND CERTIFICATE OF OCCUPANCY
VILLAGE OF ORONO, MINNESOTA
DIRECTIONS: PERMIT NUMBER
SPACES NUMBERED 1 THEM 11 MUST BE flllEO IN
BEFORE PERMIT IS ISSUED (Noose Print or Tree)
01 c
PLAT NUMBER r�`Q PARCEL NUMBER -
4. OWNER (NORM) (Address) (Tel. No.)
S. ARCHITECT (Hone) (Address .. No.)
(Tel. No.)
7. TYPE OF WORK
NEW CONSTRUCTION ❑ ALTERATIONS ❑ ADDITION O FINISH ATTIC ❑
FINISH BASEMENT ❑ PORCH O GARAGE ❑ REROOF O RESIDE ❑ MISC.
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B. SIZE OF STRUCTURE 9. NO. OF 57021119 --
10. ESTIMATED COST
(Height) (Wid1h) (Depth)
11. COMPLETION DATE 12. PROPERTY DIMENSIONS 13. NO. Of FAMILIES (1/ Applim")
14. TYPE OF CONSTRUCTION
13. PROPERTY AREA
111.
LOT AREA PER FAMILY
SQ. FT.
17. FRONT YARD
18. REAR YARD
19. SIDE YARDS
m
(1) FT (2) fT. ET. O 1t Z) FT.
20. FLOOR AREA APPORTIONMENT
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USE. AREA
:t7SO. FT.
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- _ . _ _ SQ. FT.
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$Q. FT.
AGGREGATE FLOOR AREA
FT
ACKNOWLEDG1fENT AND SIGNATURE:
The undersigned hereby represents upon all of the penalties of law, for the
purpose of inducing the Village of Orono to take the action herein requested, that
all statements herein arc true and that all work herein mentioned will be done in
accordance with the ordinance of the Village of Orono, the State of Minnesota,
and rulings of the l3uilding Dcpartincut.
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SIGNATURE APPROVED
PERMIT FEE —
PLAN CHECK FEE _
PENALTY FEE _
TOTAL FEE —_—
ZONING DISTRICT
FIRE ZONE
AGGREGATE FLOOR AREA
FLOOR AREA RATIO
OFFSTREET P/ RKING
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 ❑
PILING LOGS ❑
PLANS L SPECS. ❑ SETS
SURVEY ❑ CONES
IROPOSED GRADE FOUNDATION
N RELATION TO CURB OR CROWN
X STREET:
CERTIFICATE OF OCCUPANCY ISSUED
DATE BY