HomeMy WebLinkAbout1986-01-13 Permit, New Residence #5882CITS' of ORONO
NO)
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-73`•7
ZONING 1 RICT„
FIRE DEPARTM NT,
POST OFFICE
VAR DATE
COND USE DATE
LOT AREA
I TH_ ! DEPT�b Q
PROPOSED SETBACKS:
FRO I R SIDE
REAR / L SIDE 3S I
J-0 I
LAKE WETLANDS
ACCESS
EXISTING
A NCY-APPROV DATE
CITY
COUNTY
STATE
PRA PatLEAZSMENT
REMARKS
PERMIT NO. 5882,
(
DATE ISSUED 3
SITE ADDRESS_ k-e- (
PROPERTY IDENTIFICATION NO iPID)'
LOT BLOCK SUEDIVISION
essi
OWNER 1ddr/L�el Y
"A-
�1 rL4MTVI�(�
ARCHITECT/ENGINEER - Must Certify Multi -Family. Commercial & Industrial Const u ti Plan
(Firm) (Address) (Phone)
BUILDER (Firm)
IAddressi
(Phone)
TYPE OF WORK New Addition
Remodel
Renovate
-JS I'd eq
c
CONST TYPE
BUILDING SIZE
Estimated Construction Valuation
re'( rME_
L ZIL/ W
"7
H
OQ
OCCUPANCY-�
PERMIT FEES
CLASSIFICATION
BLDG. PERMIT
, 01)
DWELL
STORIES B 1 2 3
'
UNITS
STATE FEE
PLAN REVIEWtl-
_ Sl_0% 00
STA LLS
ATT
NUMFLF9 OF BEDRO
-
MS
DET
SEPTIC
APP DATE —
-
S
�C CHARGE
SEWER UNIT
PARK FEE
_
PROPOSED USE
PENALTY
COUNCIL
APP DATE
OTHER
INSPECTION REQUIRED WORK REQUIRING
SEPARATE PERMITS
.... FOOTING before pour
FRAMING rough -in PLUMBING
INSULATION MECHANICAL
... WALLBOARD before tapinq
.... FINAL before occupancy WELL
... SITE INSPECTION SEPTIC
WORK BEYOND OR WITHOUT A RE- SEWER /❑
QUIREO INSPECTION WILL BE SUB- WATER.. Cl
INSPECTIONSPENALTY
INSPECTIONS MUST BE CALLED -IN GRADING a FILLING El
El24 HOURS IN ADVANCE FIRE
COPY WHITE -FILE GREEN -FINANCE
CANARY -INSPECTOR GOLD -RECEIPT
PINK -ASSESSOR
are"" by a A-* Ov 1- 012111414470
TOTAL DUE JS /9
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY RFOUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED AND DECLARE`,
UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
ANCE OF ALL INFORMATION CONDITIONS AND REOUIRE-
MENTS REPRESENTED ON THIS DOCUMENT THE UNDER-
SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM-
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
OF MINNESOTTA�BUILDING
/)CODE REOUIREMENTS
Signature r� w�"1- /'�t.7L0� Date 3' 6