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01TYof OROXO <br />Building Pennit PERMIT N9 ”48591 <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-73 <br />SITE ADDRESSZONING DISTRICT <br />FIRE ZONE <br />VAR. DATE <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />FRONT R.SIDE <br />REAR L.SIOE <br />LAKE WETLANDS <br />ACCESS <br />NEW EXISTING <br />AGENCY-APPROV. DATE <br />CITY <br />COUNTY <br />STATE <br />PR. EASEMENT <br />DATE ISSlJFn <br />EXPI RES___________________ <br />I Dr- <br />LEGAL DESCRIPTION: PROP. ID. ^ I - 11^^ Ui <br />OWNER (Name) (Address) (Phon^ <br />ARCHITECT/ENGINEER - Must Certify Multi-Family, Commerci^ & Industrial Construction Plans <br />r^ERTNn <br />(Firm) (Address) (Phone) <br />BUILDER (Firm) (Address) (Phone) <br />TYPE OF WC)RK New Addition Remodel Renovate <br />CONST. TYPE BLDG. SIZE <br />L. W. Ht. <br />EST. CONST. VALUATION <br />1 <br />RESIDENTIAL STORIES B 12 3 <br />BDRMS/FLR <br />PERMIT FEES <br />BLDG. PERMIT 2-0/ <br />DWELL. <br />UNITS STATE FEE <br />GAR STALLS <br />ATT. <br />DET. <br />SEPTIC <br />APP. DATE PLAN REVIEW <br />PENALTY <br />DOCK <br />PARK FEENON RESID.PROPOSED USE <br />SAC CHARGEocc. <br />CLASS. <br />STORIES COUNCIL <br />APP. DATE TOTAL DUE <br />REMARKS:0 T^ri0siCAh(e^ V i4cc^Ac^/?Y <br />(fl T^.haraXv _________________________________ <br />7^ 4- _________________________________ <br />INSPECTION REQUIRED WORK REQUIRING <br />FOOTING bafora pour SEPARATE PERMITS <br />FRAMING rough-in <br />INSm ATIHN PLUMBING <br />WALLBOARO Bafora Taping MFCHANIDAl <br />WELL <br />SEPTIC <br />WORK BEYOND OR WITHOUT A RE SEWER <br />QUIRED INSPECTION WILL BE SUB­WVATPR <br />JECT TO PENALTY. <br />GRADING A FILLINGINSPECTION HOURS 473 7357 <br />CALL 8 - 12 A M INSP. 1 - 4 P.M. <br />CALL 1 • 4 P.M. INSP. NEXT DAY ELECTRICAL from State <br />COPY WHITE-FILE GREEN-FINANCE <br />CANARY-INSPECTOR GOLD-RECEIPT <br />PINK-ASSESSOR <br />ACKNOWLEDGEMENT <br />THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br />THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES <br />UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br />ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE­ <br />MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER­ <br />SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM­ <br />PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br />OF MINNESOTA BUILDING CODE REQUIREJ|flgNTS. <br />Signaturt <br />Approwd