HomeMy WebLinkAbout1985-11-20 Permit, New Residence #5850CITY of olt()NO
Building Permit PERMIT NO. 5850,
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZON DISTRICT
FIRE EPARTMENT
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POST OFFICE
VAR.DATE _
COND USE DATE
LOT AREA
WIDTH ADEPT
PROPOSED SETBACKS:
FRON IR SIDE
REAR I SIDE
LAKE WETLANDS
ACCESS
NE EXISTING
A APPROV DATE
CITY
COUNTY
STATE
PRIVATE EASEMENT
REMARKS
SITE ADDRESS __9 ` , $ o " OLioc "r\_ ( l�lV SZ
PROPERTY IDENTIFICATION NO IPIDI A=1 I 1` �� !�i cis oo
LOT BLOCK _ SUBDIVISION
OWNER (Name) (Address) (Phone)
ARCHITECT/ENGINEER - Must Certify Multi -Family Commercial 8 Industrial Construction Plans
(Firm) (Address) (Phone)
BUILDER (Firm)
tAddress)
Phone)
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DI(Wi 1 rt l
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TYPE OF WORK ew Addition
Remodel
Re ovate
S
CONST TYPE
BUILDING SIZE
Estimated Construction Valuation
W q0
tt
Ht�
OCCUPANCY
PE
MIT FEES
CLASSIFICATION
BLDG. PERMIT
\� S-
DWELL
STORIES B 1 3
UNITS
STATE FEE
PLAN REVIEW
GAR STALLS
ATT ✓
NUMBER OF DROOMS
DET
SEPTIC
APP DATE
SAC CHARGErJ'.�L1�
SEWER UNIT
_
PROPOSED USE
PARK FEE
PENALTY
COUNCIL
APP DATE
OTHER
TOTAL DUE
/ 47, /
INSPECTION REQUIRED
WORK REQUIRING
SEPARATE PERMITS
.... FOOTING before Dour
.... FRAMING rough -in
PLUMBING
.... INSULATION
MECHANICAL
. .. WALLBOARD before taping
.... FINAL before occupancy
WELL
...... SITE INSPECTION
SEPTIC
WORK BEYOND OR WITHOUT A RE-
SEWER
❑
QUIRED INSPECTION WILL BE SUP
❑
JECT TO PENALTY
WATER
"""'
GRADING 8 FILLING
❑
INSPECTIONS MUST BE CALLED -IN
24 HOUrS IN ADVANCE
FIRE
LJ
COPY WHITE -FILE GREEN FINANCE
CANARY -INSPECTOR GOLD RECEIPT
PINK -ASSESSOR
McMlrn htt • •OY Cc Iw fef 2f Slf w?0
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REUUESTS 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 WORK IN STRICT COM
pUANCE WITH ALL CTY OF ORONO ORDINANCES AND STATE
OF MINNESOTA BUILDING CODE REOUIREMENTS
Slgna:ure Dare,,
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