HomeMy WebLinkAbout1979-06-18 Permit, New Residence #4035CITY o ORO NOPERMIT N? 4035
Building Permit DATE ISSUED '7
AND APPLICATIGN FOR CERTIFICATE OF OCCUPANCY EXPIRES
P.O. BOX 66, CRYSTAL BAY, MN 55323 '73-7357 -
ZONING DISTRICT SITE ADDRESS '4 /
LEGAL DESCRIPTION: PROP. ID.
LOT BLOCK SUBDIVISION
FIRE ZONE
VAR. DATE
COND. USE DATE
LOT AREA
WIDTH DEPTH
PROPOSED SETBACKS
FRONT R.SIDE
REAR L.SIDE
LAKE WETLANDS
ACCESS
NEW EXISTING
AGENCY-APPROV. DATE
CITY
COUNTY
STATE
PR. EASEMENT
REMARKS
VVNjiR
ame)
(Address)
(Phone)
sO
ARCHI T/ENGINEER
— Must Certify Multi -Family, Commercial v1dustrial Construction Plans
ERT.NO.
(Firm)
(Address)
(Phone)
BUILPER '
(Firm)
(Addr ss)
(Phone)
TYPE O ORK Ne
Addition Remodel
Renovate
CONST. TYPE
BLDG. SIZE
EST. CONST. VALUATION
woo
W.
Ht.
7c
-DL.
RESIJPTIAL
STORIES B 1
2 3
PERMIT FEES
BDRMS/FLR
BLDG. PERMIT
3
DWELL. /
UNITS
STATE FEE
PLAN REVIEW
STALLS
SEPTIC
T
APP DATE
DET.
PENALTY
A
DOCK
PARK FEE
NON-RESID
PROPOSED USE
SAC CHARGES
OCC.
CLASS.
STORIES
COUNCIL
APP. DATE
TOTAL DUE
INSPECTION REQUIRED
5:.OTING before pour
F�i MING rough in
YISLJLATION
WA�,IeaCARD Before Taping
�•C/FIINNAL before occupancy
WORK BEYOND OR WITHOUT A RE
QUIRED INSPECTION WILL BE SUB-
JECT TO PENALTY.
INSPECTION HOURS 473.7157
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 --
,,I,
LECTRICAL 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 GREES TO DO ALL WORKS IN STRICT COM
PLIANCE W Y
/ QUO R INANCES AND STATE
OF MI E IL IREMFNTS.
COPY: WHITE —FILE GREEN --FINANCE
CANARY —INSPECTOR GOLD --RECEIPT
PINK —ASSESSOR
Da
v
Approve = C.ty of Orono