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APPLICATION FOR BUILDING PERM <br />AND CERTwan OF OCCUPANCY <br />VILLAGE OF ORONO, MINNESOTA <br />DIRECTION{: - <br />PERMIT NO, <br />SPACES NUTADERED 1 THRU 13 MUST BE FILLED IN <br />AI Q <br />N 3276 <br />BEFORE PERMIT IS ISSUED (Please Print or Typal <br />1 SITE ADDRESS <br />2. DATE <br />a4O ! /c C <br />3. LEGAL DESCRIPTION <br />rr PLAT NUMBER 45�5 (� PARCEL NUMBER <br />b- 4101 <br />♦ OWNER (Name) (Address) f (Tel. No.) <br />S. ARC C1 (Namel (Address) (Tel. No.) <br />6 BUILDER INN") lAddress) (Tel. No.) <br />7. TYPE OF "K <br />1g.SIZE <br />OF STRUCTURE <br />9. NO. OF STORIES <br />10. ES-IMATED COST <br />(Hint) IW.dth) (Depth) <br />11 COMPLETION DATE <br />12. PROPERTY DIMENSIONS <br />13. FAMILIES (If Appl.cablel <br />14. TYPE OF CONSTRUCTION 15 PROPERTY AREA 16 LOST AREA PER FAMILY <br />SO FT SO FT <br />17, FRONT YARD 18 REAR YARD 19 SIDE YARDS <br />d.s f <br />ACKNOWLEDGEMENT AND SIGNATURE: <br />The undersigned hereby represents upon all of the penalties of <br />law, fo- the purpose of inducing the VILLAGE OF ORONO to take <br />the action herein requested, that all statements herein are true <br />and that all work herein mentioned will be done in accordance with <br />the ordinance of the VILLAGE OF ORONO, the State of Minnesota, <br />and rulings of the Building Department. <br />--{1--- L <br />91Gl/ATUIIE--� i APPROVED <br />fy i SO.vO <br />l 0. <br />PERMIT FEE <br />STATi FEE —3o <br />dL !G , A, <br />M1f/aWED F E E <br />• /, <br />TOTAL FEE <br />ZONING DISTRICT <br />FIRE ZONE <br />AGGREGATE FLOOR AREA <br />FLOOR AREA RATIO <br />MATErIIAL FILE WITH <br />FOOTING <br />FRAMING <br />FINAL <br />CERTIFICATE OF OCCUPANCY ISSUED <br />DATE BY <br />