HomeMy WebLinkAbout1979-08-14 Permit, New Residence #4063CITY of ORO NO
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPAN'C/Y,,
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357—
ZONING DISTRICT SITE ADDRESS
LEGAL DESCRIPTION: PROP. ID..
LOT BLOCK
FIRE ZONE
VAR. DATE
COND. USE DATE
LOT AREA
WIDTH DEPTH
PROPOSED SETBACKS
FRONT R.SIDE4/
REAR L.SIDE
LAKE WETLANDS
ACCESS
NEW EXISTING
AGENCY-APPROV. DATE
CITY
COUNTY
STATE
PR. EASEMENT
REMARKS
PERMIT N? 4063
DATE ISSUED — 7—
EXPI RES
SUBDIVISION
W
( e)
(Ad ssI (Phone)
lo(o SD f�� %7 -/ O
A HITE
/ENGINEER — Must Certify Multi -Family, Commercial & Industrial Construction Plans
ERT.NO.
(Firm)
(Address) (Phone)
BUI LDE
(Firm)
(Address) (Phone)
TYPE OF WORK ew
Addition Remodel Renovate
CONST. TYPE
BLDG. SIZE
EST. CONST. VALUATION
lvez �J
'
L. W..j1 `
T Ht. CXJ
RESIDENTIAL
STORIES e
z 3
PERMIT FEES
BDRMS/FLR
BLDG. PERMIT
/
✓��
DWELL.
UNITS
3
STATE FEE 4.411,
PLAN REVIEW Ak �O
GAR. STALLS
ATT.,21/
SEPTIC
APP. DATE
DET.
PENALTY
DOCK
PARK FEE
NON-RESID.
PROPOSED USE
SAC CHARGE '7 14 O-O
OCC.
CLASS.
STORIES
COUNCIL
APP. DATE
TOTAL DUE 97X, fTv
INSPECTI,4"EQUIRED
!/�^
!/ TING before pour
F MING rough -in
LATION
SAL RD Before Taping
koo FINAL before occupancy
WORK BEYOND OR WITHOUT A RE-
OUIRED INSPECTION WILL BE SUB.
JECT TO PENALTY,
INSPECTION HOURS 473-7357
CALL 8 - 12 A.M. INSP. 1 - 4 P.M.
CALL 1 - 4 P.M. INSP. NEXT DAY
WORK REQUIRING
SEPARATE ,PERMITS
PLUMBING
MECHANICAL "
WELL �--------- -
SEPTIC
SEWER
WATER
GRADING & FILLING __.
ELECTRICAL from State
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES
UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE-
MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER-
SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM-
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
OF MINNC<OTAIUILDING CODE RQpUIREMENTS.
COPY: WHITE -FILE GREEN -FINANCE
CANARY -INSPECTOR GOLD- R17CEIPT
PINK -ASSESSOR
Signature r Date
i ��.r ��
Appro ��^ f�;j.4_City of Orono