HomeMy WebLinkAbout1980-11-26 Permit, New Residence #4395(ATY of OR()1'( )
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZONING DISTRICT SITE ADDRESS 4-ae37�
LEGAL DESCRIPTION: PROP. ID.,I
LOT R LOCk
FIRE ZONE
VAR. DATE
COND. USE DATE
LOT Art
n A�
WIDT �� DEPTH s
PROPOSED SETBACKS
FR R.SID dam"
REAR L.SIDf F4'
LAKE WETLANDS
ACCESS
NEW EXISTING
AGENCY-APPROV. DATE
CITY
I
COUNTY
STATE
PR. EASEMENT
REMARKS
PERMIT N? 4395
DATE ISSUED
_ EXPIRES
SUROI VISION
WNE
(Name)
(Address)
(P ne)
ARCHITECT/ENGINEER
— Must Certify Multi -Family, Commercial & Industrial Construction Plans
ERT.NO. --
(Firm)
(Address)
(Phone)
B U IJAVE R
(Fir
(Addr ss)
(Phone)
933 yap
TYPE WORK New
Addition Remodel
Renovate
CONSS1 TYPE
BLDG. SIZE
EST. CONST. VALUATION
L. 710& N W.
'� Ht.
/
S
RESIDENTIAL
STORIES B 1
2 3
PERM T FEES
X Q-3
BDRMS/FLR
BLDG. PERMIT
DWELL.
UNITS
STATE FEE
REVIEW3
STALLS
SEPTICPLAN
PT
APP. DATE
PENALTY
DOCK
PARK FEE
NON RESID
PROPOSED USE
SAC CHARGE
B fl
OCC.
CLASS.
STORIES
COUNCIL
TOTAL DUE
APP. DATE
oiSoi�,
INSPECTIO REQUIRED
,�QOTING before pour
___ F MING rough -in
ULATION
AL BOARD Before Taping
INAL before occupancy
WORK BEYOND OR WITHOUT A RE-
QUIRED 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
SEPARATEPERMITS
PLUMBING -v _-
MECHANICArL
WELL ✓ _
SEPTIC-____-...
SEWER -------- -----
WATER -- ---- -
GRADING & FILLING-.-----
'o"''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
-
S/GNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM-
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
OF MINNESOTA BUILDING CODE REQUIREMENTS
COPY WHITE --FILE GREEN FINANCE
CANARY -INSPECTOR GOLD RECEIPT
PINK- ASSESSOR
Signature Date/
Approved �� ty of Orono