HomeMy WebLinkAbout1985-05-22 Permit, New Residence #5626TY of OW N()
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66. CRYSTAL BAY, MN 55323 473.7357
ZONING D
7pT
FIRE DEPARTMENT
POST FFICE
VAR. DATE OF
COND. USE DATE
LOT AREA
f
WI or LEPIT �
11) IL
PROPOSED SETBACKS.
FRO / R. S /
�i�1fl L SID
LAKE WETLANDS
ACCESS
NEW XI
AGF_NCY-APPR V. DATE
CITY
GAUNTY
STATE
PRIVATE EASEMENT
REMARKS: f-t -
PERMIT NO. 5626
DATE ISSUED � —aav?
n
SITE ADDRESS
PROPERTY IDENTIFICATION NO. IPID)
LOT _BLOCK Z SUBDIVISION
0%�4ER ,gamy - (Address)
HITEgT/ENGINEER - Must Certify Multi -Fame Fv. Comrlercial3
(Firm) (Address)
.12 0 A05fI't
(Phone)
1al Construction Plans
(Phone)
BUILDER (Firm) (Address)
(Phone)
-
TYPE OF w6RK New Addition Remodel
Renovate
CONST. T;;--Y��PE
BUILDING SIZE
Estrin led Construction Valuation
L/
. � W. Ht
,
OCCUPANCY i��
1
p RMIT FEES
CL<S3IFICATI N
BLDG. PERMIT
fC7
D!A,ELL
/
STORIES B t 3
UNITS
STATE FEE
S
TALLS
NUM ER OF BED
� "'
3
PLAN REVIEW
DET
APPTDATE _
SAC CHARGE
SEWER UNIT`��
PROPOSED USE
'
PARK FEE
_
PENALTY
COUNCIL
APP. DATE
OTHER
n
TOTAL DUE
REQUIRED
ACKNOWLEDGEti:ENT
WORK REQUIRING
SEPARATE PERMITS
.. FOOTING before pour
THE UNDERSIGNED HEREBY REQUESTS PERMt8S10N TO MAKE
VINSP,ECTION
... FRAMING rough -in
PLUMBING
THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES
INSULATION
MECHANICAL
(�
UNDER PENALTY OF t eW ACKNOWLEDGEMENT AND ACCEPT -
WALLBOARD before ta; �np
FINAL Moore occupancy
WELL
ANTE OF ALL INFORMATION CONDITIONS AND REQUIRE
V. SITE NSPEr=TI,1N
SEPTIC .
MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER -
WORK BEYOND OR WITHOUT A RE-
SEWER
❑
SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COW
OUIRED INSPECTION WILL BE SUB-
WATER
❑
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
JECT TO PENALTY.
GRADING FELLING
�
❑
OF MINNESOTA BUILDING CODE REOUIRFMENTS.
INSPECTIONS MUST BE CALLED -IN
24 HOURS IN ADVANCE
FIRE.
❑
Signature Dote "� � Z �•� fr
COPY WHITE FILE GOLD RECEIPTflee i-i
GOLD RECEIPT
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IN -ASSESPECTOR
PINK-ASSESSOR
PINK•ASGo
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